Manuel Albornoz-Cabello

The short-term effect of custom-made foot orthoses in subjects with excessive foot pronation and lower back pain: A randomized, double-blinded, clinical trial:

Study design: randomized, double-blinded, clinical trial. Background: Low back pain is one of the commonest disorders affecting the back. The literature reflects how over time excessive pronation of the foot has become to be recognized as linked to chronic low back pain, and how the problem can evolve for the better with the use of compensating foot orthoses. Objectives: The main objective of this study is to answer the question of whether the use of a certain type of custom-made foot orthosis alleviates low back pain. Material and methods: In a sample of 51 participants with excessive subtalar pronation and chronic low back pain (43 women and 8 men), the effect of custom-made foot orthoses in low back pain was studied. The study design was a randomized, double-blinded, clinical trial with two groups: experimental, treated with the custom-made foot orthoses, and control, treated with a placebo. Low back pain was evaluated by a visual analog scale for pain and Oswestry’s Disability Index Questionnaire for lower back pain at two moments—on the day of inclusion in the study and after 4 weeks of treatment. Results: The evolution of the low back pain showed significant differences in the experimental group, showing a significant reduction of pain and disability (p < 0.001, visual analog scale; p < 0.001, Oswestry’s Index). Conclusions: In the sample studied, the use of custom-made foot orthoses to control foot pronation had a short-term effect in reduction of perceived low back pain. Clinical relevance If subtalar joint hyperpronation plays a fundamental role in the pathomechanics of lower limb, and this can facilitate the development of low back pain, then controlling the abnormal mobility of subtalar joint by means of foot orthoses should improve this symptom. This article could help solve this controversy.

Craniocervical Posture and Trigeminal Nerve Mechanosensitivity in Subjects with a History of Orthodontic Use: A Cross-Sectional Study

Abstract The purpose of the study was to evaluate whether, in asymptomatic subjects, there are differences in: (i) head posture while sitting and standing still and (ii) trigeminal nerve mechanosensitivity, between those who have a history of using orthodontics and those who do not. The sample consisted of 72 subjects (21±2.14 years): one group who had used orthodontics in the past (n=37), and another group who had not had previous orthodontic treatment (n=35). The authors measured the CranioVertebral Angle (CVA) while the subject was sitting and standing still by means of lateral photographs, and the pressure pain threshold (PPT) of the trigeminal nerve. The orthodontics group showed a more upright position of the head when sitting compared to the non-orthodontics group, with the difference being statistically significant (ANOVA test; p<0.001; F1,70=16.705; R2=0.19), but not for the standing position (p=0.538). The values of the PPT in the trigeminal nerve (supraorbital-V1, infraorbital-V2 and mandibular- V3) were lower on both sides (dominant and nondominant) in the non-orthodontics group. The between-group comparison (ANOVA test) showed statistically significant differences for the trigeminal nerve PPT in its different branches (V1 p=0.001; F1,70=13.012; R2=0.15) (V2 p=0.004; F1,70=9.103; R2=0.11) (V3 p=0.005; F1,70=8.228; R2=0.10). Based on these observations, it was concluded that subjects with a history of orthodontic use show a better sitting craniocervical posture and mechanosensitivity of the trigeminal nerve branches compared to the group that had not used orthodontics in the past.

A comparison of acute effects between Kinesio tape and electrical muscle elongation in hamstring extensibility.

BACKGROUND To improve hamstring extensibility some methods have been analyzed and compared for determining their acute and chronic effectiveness. OBJECTIVE To compare the immediate effect of electrical muscle elongation (EME) versus Kinesio tape (KT) in hamstring muscle extensibility. METHODS One hundred and twenty adult amateur athletes with hamstring shortness (straight leg raise test angle <80◦) were randomly assigned to a group: group 1 (EME session of 4 KHz interferential current, bipolar technique and AMF = 100 Hz, n = 40), group 2 (KT, n = 40) or group 3 (control group, no intervention, n = 40). Hamstring extensibility was assessed before and after the intervention through the active knee extension test. Results: Significant improvements were found in both EME and KT groups whereas no changes were detected in the control group. However, no significant differences between both techniques were detected. The EME group showed large effect size (d = 0.843) while the KT group reached medium effect size (d = 0.431). CONCLUSIONS Both electrical muscle elongation and Kinesio tape are effective techniques in the short-term in amateur athletes with decreased hamstring extensibility. The higher increase of hamstring extensibility, with a better clinical effect was achieved with the application of electrical muscle elongation. However, no significant differences were found when comparing the effectiveness of both techniques.

Effect of interferential current therapy on pain perception and disability level in subjects with chronic low back pain: A randomized controlled trial

Objective: To assess the short-term efficacy of transregional interferential current therapy on pain perception and disability level in chronic non-specific low back pain. Design: A randomized, single-blinded (the assessor collecting the outcome data was blinded), controlled trial. Setting: A private physiotherapy research clinic. Subjects: A total of 64 individuals, 20 men and 44 women, mean (SD) age was 51 years (11.93), with low back pain of more than three months, with or without pain radiating to the lower extremities above the knee, were distributed into a control (n = 20) or an experimental group (n = 44). A 2:1 randomization ratio was used in favour of the latter. Interventions: A transregional interferential current electrotherapy protocol was performed for participants in the experimental group, while the control group underwent a ‘usual care’ treatment (massage, mobilization and soft-tissue techniques). All subjects received up to 10 treatment sessions of 25 minutes over a two-week period, and completed the intervention and follow-up evaluations. Outcome measures: Self-perceived pain was assessed with a Visual Analogue Scale. Secondary measure included the Oswestry Low Back Disability Index. Evaluations were collected at baseline and after the intervention protocol. Results: Significant between-group differences were found for interferential current therapy on pain perception (p = 0.032) and disability level (p = 0.002). The observed differences in the between-group mean changes were of 11.34 mm (1.77/20.91) and 13.38 points (4.97/21.78), respectively. Conclusions: A two-week transregional interferential current treatment has shown significant short-term efficacy, when compared with a ‘usual care’ protocol, on self-perceived pain and functionality in subjects with chronic low back pain.

Normal Values of Metatarsal Parabola Arch in Male and Female Feet

There is not any method to measure metatarsal protrusion in the whole metatarsal. The aim of this research is to know the normal metatarsal parabola in male and female feet. The system of measurement devised by Hardy and Clapham to evaluate the protrusion between metatarsals I and II was adapted to study the whole metatarsal parabola and applied to the five metatarsals of 169 normal feet, 72 female feet and 97 male feet. Authors measured all metatarsal protrusion relative to metatarsal II. The results obtained show a female metatarsal protrusion relative to metatarsal II of +1.27% for metatarsal I, −3.36% for metatarsal III, −8.34% for metatarsal IV, and −15.54% for metatarsal V. Data obtained for male metatarsal parabola were +0.5% for metatarsal I, −3.77 for metatarsal III, −9.57 for metatarsal IV, and −17.05 for metatarsal V. Differences between both metatarsal parabola were significant.

Efficacy of monopolar dielectric transmission radio frequency in panniculus adiposus and cellulite reduction

ABSTRACT Introduction: Despite high incidence rate of cellulite, there are few studies regarding its treatment. Most of them present non-validated evaluation tools. Radio frequency is a focused treatment very used in aesthetics to reduce it. Objectives: To know the efficacy of Monopolar Dielectric Radio frequency (MDR) treatment in dynamic applications to reduce cellulite, panniculus adiposus and gluteal and posterior thigh regions. Methods: Experimental study consisting of inferior members of nine women. They received 10 sessions based on dynamic applications of MDR. Variables included the following: Cellulite Severity Scale (CSS), appearance of the cutaneous area, flaccidity and ultrasound measurement of the panniculus adiposus. Results: The final CSS score of the leg treated reflects statistically significative differences (p = 0.023) when compared with control leg (p = 0.622). Significant reductions of body perimeters at the level of the great trochanter (p = 0.02), the gluteal region (p = 0.03) and the midpoint of the posterior thigh (p = 0.01) are found. The reduction of the panniculus adiposus measured using ultrasound techniques shows significant changes in the midpoint of the posterior thigh (p = 0.028) as well as in the gluteal region (p = 0.03). Conclusions: The dynamic application of MDR seems to be effective in order to reduce not only the thickness of panniculus adiposus but also gluteal and posterior thigh perimeters.

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.

Treatment of clubfoot with the modified Copenhagen method: A 10-year follow-up

Background: Clubfoot is one of the most frequent congenital malformations in the world. Non-operative methods follows limiting surgery to a minimum. The modified Copenhagen method has not been studied enough. Study Design: longitudinal retrospective study. Objectives: To evaluate prognostic factors for clinical rehabilitation with the modified Copenhagen method in a 10-year follow-up period. Methods: A retrospective study was carried out on a 10-year follow-up of 82 children diagnosed with clubfoot at birth and treated with the modified Copenhagen method. Their sex, side, severity, bilaterality, forefoot orientation, and age when the nonoperative treatment was started were registered, and a cluster analysis was performed to determine which variables were most significant for predicting whether surgical treatment was needed. Results: Of the clubfeet, 13.4% were grade I, 65.9% were grade II, and 20.7% were grade III according to the Harrold and Walker classification. In total, 58 patients needed surgery at some point during the follow-up period. The severity and talo-first metatarsal angle made it possible to determine whether the patients required surgery in 68% (56/82) of the cases. Conclusion: The results of the study suggest the possibility of providing physicians with an algorithm which might facilitate assessing whether the children will require surgery or not, depending on the data obtained from the cluster analysis. Clinical relevance This study provides health professionals with an algorithm that might facilitate assessing whether the children will require surgery or not.