María Encarnación Aguilar-Ferrándiz

Effects of Kinesio Taping on Venous Symptoms, Bioelectrical Activity of the Gastrocnemius Muscle, Range of Ankle Motion, and Quality of Life in Postmenopausal Women With Chronic Venous Insufficiency: A Randomized Controlled Trial

OBJECTIVE To assess the efficacy of Kinesio taping (KT) on venous symptoms, quality of life, severity, pain, edema, range of ankle motion (ROAM), and peripheral muscle myoelectrical activity in lower limbs of postmenopausal women with mild chronic venous insufficiency (CVI). DESIGN Double-blinded randomized controlled trial with concealed allocation. SETTING Clinical setting. PARTICIPANTS Consecutive postmenopausal women (N=123; age range, 62-67y) with early-stage CVI. None of the participants withdrew because of adverse effects. INTERVENTION Participants were randomly assigned to an experimental group for standardized KT application for external gastrocnemius (EG) and internal gastrocnemius (IG) muscle enhancement and ankle function correction or a placebo control group for sham KT application. Both interventions were performed 3 times a week during a 4-week period. MAIN OUTCOME MEASURES Venous symptoms, CVI severity, pain, leg volume, gastrocnemius electromyographic data, ROAM, and quality of life were recorded at baseline and after treatment. RESULTS The experimental group evidenced significant improvements in pain distribution, venous claudication, swelling, heaviness, muscle cramps, pruritus, and CVI severity score (P≤.042). Both groups reported significant reductions in pain (experimental group: 95% confidence interval [CI], 1.6 to 2.1; control group: 95% CI, -0.2 to 0.3). There were no significant changes in either group in quality of life, leg volume, or ROAM. The experimental group showed significant improvements in root mean square signals (right leg: EG 95% CI, 2.99-5.84; IG 95% CI, 1.02-3.42; left leg: EG 95% CI, 3.00-6.25; IG 95% CI, 3.29-5.3) and peak maximum contraction (right leg: EG 95% CI, 4.8-22.7; IG 95% CI, 2.67-24.62; left leg: EG 95% CI, 2.37-20.44; IG 95% CI, 2.55-25.53), which were not changed in controls. CONCLUSIONS KT may reduce venous symptoms, pain, and their severity and enhance gastrocnemius muscle activity, but its effects on quality of life, edema, and ROAM remain uncertain. KT may have a placebo effect on venous pain.

Short-term effects of interferential current electro-massage in adults with chronic non-specific low back pain: a randomized controlled trial:

Objectives: To analyse the effectiveness of a combined procedure of massage and electrotherapy with interferential current in individuals with chronic non-specific low back pain of mechanical aetiology. Design: A single blinded randomized controlled trial. Setting: Clinical setting. Participants: Sixty-two individuals with chronic non-specific low back pain were randomly assigned to an experimental or control group. For 10 weeks the experimental group underwent treatment comprising 20 sessions (twice a week) of massage with interferential current in the lumbar and dorsal–lumbar area, and the control group received superficial lower back massage (effleurage, superficial pressure and skin rolling). Main outcome variables: Oswestry Disability Index, pain visual analogue scale, Tampa Scale for Kinesiophobia, Roland Morris Disability Questionnaire, McQuade Test, Side Bridge Test, quality of life scores and the range of trunk anteflexion motion, which were all assessed before the treatment and immediately after the last treatment session. Results: The 2 × 2 mixed model ANOVA with repeated measurements showed statistically significant group * time interactions for the visual analogue scale (F = 12.839; P = 0.001), Oswestry Disability Index (F = 5.850; P = 0.019), Roland Morris Disability Questionnaire (F = 8.237; P = 0.006) and quality of life (physical function (F = 16.792; P = 0.001), physical role (F = 14.839; P = 0.001) and body pain (F = 11.247; P = 0.001)). Conclusions: In individuals with chronic non-specific low back pain, interferential current electro-massage achieved a significantly greater improvement in disability, pain and quality of life in comparison to superficial massage after 20 treatment sessions.

Comparative study on the effectiveness of myofascial release manual therapy and physical therapy for venous insufficiency in postmenopausal women

OBJECTIVES Venous insufficiency is present in a large number of postmenopausal women, increasing their risk of disability. The objective of this study was to determine the effects of myofascial release therapy and conventional kinesiotherapy on venous blood circulation, pain and quality of life in postmenopausal patients with venous insufficiency. METHODS A randomised controlled trial was undertaken. We enrolled 65 postmenopausal women with stage I or II venous insufficiency on the clinical, aetiological, anatomical and physiopathological (CEAP) scale of venous disorders, randomly assigning them to a control (n=32) or experimental (n=33) group. The control and experimental group patients underwent physical venous return therapy (kinesiotherapy) for a 10-week period, during which the experimental group patients also received 20 sessions of myofascial release therapy. Main outcome measures determined pre- and post-intervention were blood pressure, cell mass, intracellular water, basal metabolism, venous velocity, skin temperature, pain and quality of life. RESULTS Basal metabolism (P<0.047), intracellular water (P<0.041), diastolic blood pressure (P<0.046), venous blood flow velocity (P<0.048), pain (P<0.039) and emotional role (P<0.047) were significantly higher in the experimental group than in the control group after the 10-week treatment programme. CONCLUSION The combination of myofascial release therapy and kinesiotherapy improves the venous return blood flow, pain and quality of life in postmenopausal women with venous insufficiency.

Effect of a Mixed Kinesio Taping–Compression Technique on Quality of Life and Clinical and Gait Parameters in Postmenopausal Women With Chronic Venous Insufficiency: Double-Blinded, Randomized Controlled Trial

OBJECTIVE To investigate the short-term effect of a mixed Kinesio taping (KT) model on range of ankle motion (ROAM), gait, pain, perimeter of lower limbs, and quality of life in postmenopausal women with chronic venous insufficiency (CVI). DESIGN Double-blinded, randomized controlled trial. SETTING Clinical setting. PARTICIPANTS Consecutive postmenopausal women (N=130; mean age ± SD, 65.44±14.7y) with mild CVI. No participant withdrew because of adverse effects. INTERVENTION Participants were randomly assigned to either (1) an experimental group to receive a mixed KT-compression treatment following KT recommendations for gastrocnemius muscle enhancement and functional correction of the ankle, and adding 2 tapes to simulate traditional compression bandages (no KT guidelines); or (2) a placebo control group for sham KT. Both interventions were performed 3 times a week during a 4-week period. MAIN OUTCOME MEASURES ROAM, gait, pain, perimeter of right and left lower limb, and quality of life were assessed at baseline and 48 hours posttreatment. RESULTS Quality of life was better in the intervention group by a mean of 8.76 points (95% confidence interval [CI], 4.96-12.55). The experimental group also showed significant pre-/posttreatment improvements in both lower limbs in gait dorsiflexion ROAM (95% CI, 1.02-2.49), cadence (95% CI, 3.45-1.47), stride length (95% CI, 21.48-10.83), step length (95% CI, 1.68-6.61), stance phase (95% CI, 61-107), and foot (95% CI, .56-.92) and malleolus (95% CI, 1.15-1.63) circumference. None of these variables were significantly modified in the placebo group. Both groups reported a significant reduction in pain. CONCLUSIONS Ankle dorsiflexion during gait, walking parameters, peripheral edema, venous pain, and quality of life remain improved in patients with CVI at 1 month after mixed KT-compression therapy. KT may have a placebo effect on pain perception.

Short-term effectiveness of spinal manipulative therapy versus functional technique in patients with chronic nonspecific low back pain: a pragmatic randomized controlled trial.

BACKGROUND CONTEXT Chronic low back pain (LBP) is a prevalent condition associated with pain, disability, decreased quality of life, and fear of movement. To date, no studies have compared the effectiveness of spinal manipulation and functional technique for the management of this population. PURPOSE This study aimed to compare the effectiveness of spinal manipulation and functional technique on pain, disability, kinesiophobia, and quality of life in patients with chronic LBP. STUDY DESIGN/SETTING A single-blind pragmatic randomized controlled trial conducted in a university research clinic was carried out. PATIENT SAMPLE Sixty-two patients (62% female, age: 45±7) with chronic LBP comprised the patient sample. OUTCOME MEASURES Data on disability (Roland-Morris Disability Questionnaire [RMQ], Oswestry Low Back Pain Disability Index [ODI]), pain intensity (Numerical Pain Rate Scale [NPRS]), fear of movement (Tampa Scale of Kinesiophobia [TSK]), quality of life (Short Form-36 [SF-36] quality of life questionnaire), isometric resistance of abdominal muscles (McQuade test), and spinal mobility in flexion (finger-to-floor distance) were collected at baseline immediately after the intervention phase and at 1 month postintervention by an assessor blinded to group allocation of the patients. METHODS Patients were randomly assigned to the spinal manipulative therapy group or the functional technique group and received three once-weekly sessions. RESULTS In comparison to patients receiving functional technique, those receiving spinal manipulation experienced statistically, although not clinically, significant greater reductions in terms of RMQ (standardized mean difference in score changes between groups at post-treatment: 0.1; at 1 month: 0.1) and ODI (post-treatment: 2.9; at 1 month: 1.4). Linear longitudinal analysis showed a significant improvement in both groups over time for RMQ (manipulative: F=68.51, p<.001; functional: F=28.58, p<.001) and ODI (manipulative: F=104.66, p<.001; functional: F=32.15, p=.001). However, significant treatment-by-time interactions were not detected for pain intensity (p=.488), TSK (p=.552), any domains of the SF-36 quality of life questionnaire (p≤.164), McQuade test (p=.512), and finger-to-floor distance (p=.194). Differences between and within groups were not clinically meaningful in any of the reported measures. CONCLUSIONS In comparison to functional technique, spinal manipulative therapy showed greater reduction in disability in patients with chronic LBP, but not in terms of pain, fear of movement, quality of life, isometric resistance of trunk flexors, or spinal mobility. However, differences in disability were not clinically meaningful; therefore, spinal manipulative therapy did not result in any clinically important short-term benefits over functional technique therapy. In addition, as neither group met the threshold for minimum clinically important difference following treatment, neither treatment resulted in a clinically meaningful benefit.

Short-term effects of a manual therapy protocol on pain, physical function, quality of sleep, depressive symptoms, and pressure sensitivity in women and men with fibromyalgia syndrome: a randomized controlled trial.

Objective:To investigate the therapeutic effects of a manual therapy protocol for improving pain, function, pressure pain thresholds (PPT), quality of sleep, and depressive symptoms in women and men with fibromyalgia syndrome (FMS). Materials and Methods:Eighty-nine patients were randomly assigned to experimental or control group. The experimental group (24 female, 21 male) received 5 sessions of manual therapy and the control group (24 female, 21 male) did not receive any intervention. PPT, pain, impact of FMS symptoms, quality of sleep, and depressive symptoms were assessed in both groups at baseline and after 48 hours of the last intervention in the experimental group. Results:The analysis of covariance found significant Group×Time×Sex interactions for McGill PPI and Center for Epidemiologic Studies Depressive Symptoms Scale (P<0.01) was also found: men exhibited a larger effect size for depressive symptoms than women, whereas women exhibited a greater effect size than men in the McGill PPI. A significant Group×Time×Sex interaction for PPT over suboccipital, upper trapezius, supraspinatus, second rib, gluteal region, and tibialis anterior muscle was also found: men included in the experimental group experienced significant greater improvements in PPT as compared with women with FMS in the experimental group. Conclusions:Manual therapy protocol was effective for improving pain intensity, widespread pressure pain sensitivity, impact of FMS symptoms, sleep quality, and depressive symptoms. In addition, sex differences were observed in response to treatment: women and men get similar improvements in quality of sleep and tender point count, whereas women showed a greater reduction in pain and impact of FMS symptoms than men, but men reported higher decreases in depressive symptoms and pressure hypersensitivity than women.

Prevención del linfedema tras cirugía de cáncer de mama mediante ortesis elástica de contención y drenaje linfático manual: ensayo clínico aleatorizado.

BACKGROUND AND OBJECTIVE Secondary lymphoedema is considered one of the most common complications after breast cancer surgery. The aim of the present study was to analyze the effectiveness of containment elastic orthosis and manual lymphatic drainage in the prevention of lymphoedema secondary to mastectomy. PATIENTS AND METHOD An experimental study was performed with a control group. Forty-eight patients were randomly assigned to experimental (containment elastic orthosis and manual lymphatic drainage) and control (postural measures) groups. Outcomes measures were quality of life, body composition, temperature, functional assessment of the shoulder, pain and limb volume. Measures were performed at baseline and after 8-months intervention. RESULTS After the intervention period, the experimental group showed significant differences (P<.05) in the quality of life, extracellular water, and functional assessment of the volume of the limb of the mastectomized side. CONCLUSIONS The application of containment elastic orthosis and manual lymphatic drainage contribute to prevent secondary lymphoedema after breast cancer surgery, improving the quality of life in these patients.

Effectiveness of mirror therapy, motor imagery, and virtual feedback on phantom limb pain following amputation: A systematic review:

Background: Phantom limb pain is reported in 50%–85% of people with amputation. Clinical interventions in treating central pain, such as mirror therapy, motor imagery, or virtual visual feedback, could redound in benefits to amputee patients with phantom limb pain. Objectives: To provide an overview of the effectiveness of different techniques for treating phantom limb pain in amputee patients. Study design: Systematic review. Methods: A computerized literature search up to April 2017 was performed using the following databases: PubMed, Scopus, CINAHL, MEDLINE, ProQuest, PEDro, EBSCOhost, and Cochrane Plus. Methodological quality and internal validity score of each study were assessed using PEDro scale. For data synthesis, qualitative methods from the Cochrane Back Review Group were applied. Results: In all, 12 studies met our inclusion criteria, where 9 were rated as low methodological quality and 3 rated moderate quality. All studies showed a significant reduction in pain, but there was heterogeneity among subjects and methodologies and any high-quality clinical trial (PEDro score ≤8; internal validity score ≤5) was not found. Conclusion: Mirror therapy, motor imaginary, and virtual visual feedback reduce phantom limb pain; however, there is limited scientific evidence supporting their effectiveness. Future studies should include designs with more solid research methods, exploring short- and long-term benefits of these therapies. Clinical relevance This systematic review investigates the effectiveness of mirror therapy, motor imagery, and virtual visual feedback on phantom limb pain, summarizing the currently published trials and evaluating the research quality. Although these interventions have positive benefits in phantom limb pain, there is still a lack of evidence for supporting their effectiveness.

Effects of tap water iontophoresis and psychological techniques on psychosocial aspects of primary palmar hyperhidrosis

ejd.2010.1214 Auteur(s) : Maria Encarnacion AGUILAR-FERRANDIZ1, Carmen MORENO-LORENZO1, Guillermo Adolfo MATARAN-PENARROCHA2, Adelaida Maria CASTRO-SANCHEZ3 adelaid@ual.es, Maria Isabel PERALTA-RAMIREZ4, Ricardo RUIZ-VILLAVERDE5 1 Department of Physical Therapy, University of Granada, Spain 2 Health District Malaga (North), Andalusian Health Service, Malaga, Spain 3 Department of Nursing and Physical Therapy, Carretera de Sacramento s/n. Facultad de Ciencias de la Salud, Universidad de Almeria, [...]

Influence of upper limb disability, manual dexterity and fine motor skill on general self-efficacy in institutionalized elderly with osteoarthritis

STUDY DESIGN Descriptive, cross-sectional. INTRODUCTION The impact of upper limb (UL) disability, dexterity and fine motor skill on self-efficacy in older adults with osteoarthritis (OA) is not well known yet. PURPOSES OF THE STUDY To evaluate the self-efficacy and its relationship with UL function/disability in institutionalized OA. METHODS Institutionalized adults (n = 45) over the age of 65 years with OA were evaluated in a single session, to determine pinch strength, active range of motion of the hand and UL disability and functionality. They were classified as self-efficacious or not based on their general self-efficacy level. The influence on self-efficacy on upper limb function was statistically analyzed using bivariate and multivariate regression analyses. RESULTS Self-effective older adults showed significantly lower scores in disability and higher scores in pinch strength, dexterity and motion of thumb than those who were classified as non-self-effective. Self-efficacy was associated with pinch strength (p ≤ 0.038), disability (p < 0.001) and dexterity (p ≤ 0.048). Multiple regression analyses showed that disability explained almost 40% of the variability of self-efficacy. CONCLUSIONS Older adults classified as non-self-effective have higher UL disability and less pinch strength, manual dexterity and thumb motion than those who are self-effective, suggesting a relationship between impairment and perceived ability.