Juan Rodríguez-Mansilla

The effects of ear acupressure, massage therapy and no therapy on symptoms of dementia: A randomized controlled trial

Objective: To assess the effectiveness of ear acupressure and massage vs. control in the improvement of pain, anxiety and depression in persons diagnosed with dementia. Design: A pilot randomized controlled trial. Setting: Residential homes in Extremadura (Spain). Subjects: A total of 120 elders with dementia institutionalized in residential homes. Intervention: The participants were randomly allocated, in three groups. Control group – they continued with their routine activities; ear acupressure intervention group – they received ear acupressure treatment (pressure was applied to acupressure points on the ear); and massage therapy intervention group – they received relaxing massage therapy. Main measures: The variables pain, anxiety and depression were assessed with the Doloplus2, Cornell and Campbell scales. The study was carried out during five months; three months of experimental treatment and two months with no treatment. The assessments were done at baseline, each month during the treatment and at one and two months of follow-up. In the statistical analysis the three groups were compared with each other. Results: A total of 111 participants completed the study. Their aged ranged from 67 to 91 years old and 86 of them (77.4%) were women. The ear acupressure intervention group showed better improvements than the massage therapy intervention group in relation to pain and depression during the treatment period and at one month of follow-up. The best improvement in pain was achieved in the last (3rd) month of ear acupressure treatment (p  < 0.001) being the average improvement 8.55 (4.39) with IC 95% (7.14, 9.95). Regarding anxiety, the best results were also observed in the last month of treatment. The average improvement in anxiety was 9.63 (5.00) with IC 95% (8.02, 11.23) Conclusions: Ear acupressure and massage therapy showed better results than the control group in relation to pain, anxiety and depression. However, ear acupressure achieved more improvements.

Ear therapy and massage therapy in elderly people with dementia a pilot study

Objective To assess the impact of massage versus ear acupuncture on behavior and participation in occupational therapy of dementia patients. Methods We performed a controlled, randomized longitudinal trial approved by the Bioethics Commission of the University of Extremadura. One hundred twenty elderly subjects with dementia institutionalized in residential homes in Extremadura (Spain) received treatment based on massage and ear acupuncture over three months. Behavior alterations, sleep disturbance, and participation in rehabilitation and eating were assessed every month during the three months of intervention, and at one and two months of follow-up after the end of treatment. The assessment was performed through a structured questionnaire with closed format questions done by an occupational therapist not involved in the study. Results There was a statistically significant positive effect of massage and ear acupuncture (P Conclusion Massage therapy and ear acupuncture can improve behavior and sleep disturbances, and increase the participation in eating and rehabilitation organized in residential homes, in dementia patients.

Escalas de valoración del dolor en pacientes con demencia. Instrumentos de ayuda para el fisioterapeuta, el médico, el enfermero y el terapeuta ocupacional

The purpose of this study was to determine which scales are being used to evaluate pain in old people suffering from dementia. A search strategy was developed to retrieve all articles (randomized controlled trials and clinical trials without randomization) published in MEDLINE, Cochrane Library Plus, PEDro and Dialnet and BMC Geriatrics from January 2000 to January 2012. Exclusion criteria were articles that did not use scales for evaluating pain in elderly patients suffering from dementia, and other type of articles (case studies, reviews...). Finally, 13 studies were included in this review. From the results obtained it appears that more studies are needed to confirm the pain scales used for the elderly suffering from dementia. Observational scales may be useful to evaluate pain in these patients.

Recuperación de la artroplastia de rodilla a través de la movilización pasiva continua

The purpose of this study was to know the effects of continuous passive mobilization in patients who underwent total knee arthroplasty. A search strategy was developed to retrieve all clinical trials, written in English and/or Spanish, published in the electronic search databases PubMed, Cochrane Library Plus, Dialnet, CSIC and PEDro. The inclusion criteria were: clinical trials published from January 2000 until November 2014 in English or Spanish. Out of 537 clinical trials that were potentially relevant, a total of 12 were included in this review. The evaluation of 1,153 patients shows that there is no significant difference in improving the range of the joint, pain, balance, motion, healing and hospital stay using continuous passive mobilization against the regular physiotherapy treatment for total knee arthroplasty. The application of continuous passive mobilization in the long-term does not provide any benefit in terms of the breadth of the range of the joint, pain and improvement of standing and motion in comparison with conventional postoperative physiotherapy treatment in total knee arthroplasty. In the short term an improvement is obtained in the range of joint motion in knee flexion.

Effectiveness of dry needling on reducing pain intensity in patients with myofascial pain syndrome： a Meta-analysis

OBJECTIVE To summarize the literature about the effectiveness of dry needling (DN) on relieving pain and increasing range of motion (ROM) in individuals with myofascial pain syndrome (MPS). METHODS Papers published from January 2000 to January 2013 were identified through an electronic search in the databases MEDLINE, Dialnet, Cochrane Library Plus, Physiotherapy Evidence Data-base (PEDro) and Spanish Superior Council of Scientific Research (CSIC). The studies included were randomized controlled trials written in English and/or Spanish about the effectiveness of DN on pain and ROM in individuals with MPS. RESULTS Out of 19 clinical trials that were potentially relevant, a total of 10 were included in the Meta-analysis. Regarding pain intensity reduction when measured before and immediately after the intervention, DN achieved improvement compared with the placebo treatment [d = - 0.49; 95% CI (- 3.21, 0.42)] and with the control group [d = - 9.13; 95% C (- 14.70, - 3.56)]. However, other treatments achieved better results on the same variable compared with DN, considering the measurements for pre-treatment and immediately after [d = 2.54; 95% CI (- 0.40, 5.48)], as well as the pre-treatment and after 3-4 weeks [d = 4.23; 95% CI (0.78, 7.68)]. DN showed a significantly increased ROM when measured before the intervention and immediately after, in comparison with the placebo [d = 2.00; 95% C (1.60, 2.41)]. However, other treatments achieved a significant better result regarding ROM when it was measured before the intervention and immediately after, as compared with DN [d = - 1.42; 95% CI (- 1.84, - 0.99)]. CONCLUSION DN was less effective on decreasing pain comparing to the placebo group. Other treatments were more effective than DN on reducing pain after 3-4 weeks. However, on increasing ROM, DN was more effective comparing to that of placebo group, but less than other treatments.

Epidemiological data on acupuncture and physical and rehabilitation medicine in the European Union.

OBJETIVE To know the prevalence of acupuncturists within physical and rehabilitation medicine specialists in Europe and their characteristics, as well as to analyze the pathologies treated and therapeutic techniques used. METHODS This is a cross-sectional descriptive study based on a structured and closed questionnaire. The study was carried out from October 2011 to May 2014. RESULTS A total of 115 specialists from 19 countries completed the questionnaire. The mean characteristics of the physical and rehabilitation medicine (PRM) specialists who are also acupuncturists in Europe were: women (62.6 %); mean age of 47.91 years old; 4.20 years of physical and rehabilitation medicine school and 2.00 years of acupuncture training; 15.03 years of mean time of clinical practice as physical and rehabilitation medicine specialists and 10.42 years of experience as acupuncturists; 35.65 % had a doctorate (PhD) degree, obtained at a mean age of 33.55 years old; working in a public hospital (80%); treating mainly neurological conditions (48.1% ) and using mainly techniques such as kinesiotherapy (11.81%), orthosis (10.40%) and electrotherapy (9.92%). Acupuncture was applied by 32.2% of the participants mainly in musculoskeletal conditions (27.38%). A mean number of more than 20 patients a day were treated by 47.04% of the specialists, being 41.8% of the patients (adults and children). Significant differences were found between the variables, acupuncture and gender (Pearsons correlation Index = 0.007). However, no differences were observed in relation to acupuncture and age, doctorate degree, years of clinical practice and workplace (all with P values > 0.05). CONCLUSION In the European area, physical and rehabilitation medicine specialists who are also acupuncturists are mainly female, middle-aged, with 15 years of professional experience, PhD holders, working in public hospitals, treating mainly neurological conditions with kinesiotherapy and acupuncture, and treating over 20 patients a day (adults and children) during a 7 h shift. Further epidemiological studies on PRM to provide more information regarding the real situation of this medical specialty and the possibility to open to Chinese traditional medicine techniques such as acupuncture are necessary.

DRY NEEDLING IN THE MANAGEMENT OF MYOFASCIAL TRIGGER POINTS: A SYSTEMATIC REVIEW OF RANDOMIZED CONTROLLED TRIALS

OBJECTIVE This systematic review of randomized controlled trials aimed to examine the effectiveness of dry needling in the treatment of myofascial trigger points and to explore the impact of specific aspects of the technique on its effectiveness. METHODS Relevant studies published between 2000 and 2015 were identified by searching PubMed, Scopus, The Cochrane Library and Physiotherapy Evidence Database. Studies identified by electronic searches were screened against a set of pre-defined inclusion criteria. RESULTS Fifteen studies were included in this systematic review. The main outcomes that were measured were pain, range of motion, disability, depression and quality of life. The results suggest that dry needling is effective in the short term for pain relief, increase range of motion and improve quality of life when compared to no intervention/sham/placebo. There is insufficient evidence on its effect on disability, analgesic medication intake and sleep quality. CONCLUSIONS Despite some evidence for a positive effect in the short term, further randomized clinical trials of high methodological quality, using standardized procedures for the application of dry needling are needed.

Efeitos da aplicação de massagem terapêutica em crianças com câncer: uma revisão sistemática

ABSTRACT Objective: to learn about the effects of the use of therapeutic massage in children with cancer. Method: systematic review of controlled clinical trials The search was conducted in November 2014 in the following databases: Pubmed, CSIC, Dialnet, Scopus, Cochrane and PEDro. Inclusion criteria were: clinical trials, published in English or Spanish, analyzing the effects of massage on the different stages and types of childhood cancer (between 1 and 18 years old). Results: of 1007 articles found, 7 met the inclusion criteria. Their authors use different massage techniques (Swedish massage, effleurage, petrissage, frictions, pressures), obtaining benefits in the symptoms present during the illness (decrease of pain, nausea, stress, anxiety and increase of white blood cells and neutrophils). Conclusion: therapeutic massage improves the symptoms of children with cancer, but there is a need for more research that may support the effects attributed to it.Objetivo: conocer los efectos del uso del masaje terapeutico en ninos con cancer. Metodo: revision sistematica de ensayos clinicos controlados la busqueda se llevo a cabo en noviembre de 2014 en las bases de datos cientificas: Pubmed, CSIC, Dialnet, Scopus, Cochrane y PEDro. Los criterios de inclusion han sido: ensayos clinicos, publicados en ingles o espanol, en los que se analizaran los efectos del masaje en las diferentes etapas y tipos de cancer infantil (entre 1 y 18 anos). Resultados: de 1007 articulos localizados, 7 cumplieron los criterios de inclusion. Sus autores utilizan diferentes tecnicas de masaje (masaje sueco, effleurage, petrissage, fricciones, presiones), obteniendo beneficios en los sintomas presentes durante la enfermedad (disminucion del dolor, nauseas, estres, ansiedad y aumento de globulos blancos y neutrofilos). Conclusion: el masaje terapeutico mejora los sintomas de los ninos con cancer, que respalden los efectos que se le atribuyen.

Burnout syndrome prevalence in physiotherapists

Objective: To evaluate burnout syndrome in its three aspects, jointly as well as independently, in physiotherapists from the Extremadura region (Spain). Method: Analytic descriptive epidemiological transversal trial in primary care and institutional practice, with physiotherapists practicing in Extremadura who met the inclusion criteria, after having signed an informed consent form. Emotional exhaustion, depersonalization and low professional accomplishment were the outcomes measured. Results: Physiotherapists from Extremadura show a 65.23 point level of burnout syndrome, according to the Maslach Burnout Inventory questionnaire. Therefore, they are positioned in the middle of the rating scale for the syndrome, and very near to the high level at starting score of 66 points. Conclusion: Physiotherapists in Extremadura present moderate scores for the three dimensions of burnout syndrome, namely, emotional exhaustion, depersonalization and low professional accomplishment. For this reason, they are in the moderate level of the syndrome and very near to the high level, which starts at a score of 66 points. No relation between burnout syndrome and age has been found in our study.