Rafael Lomas-Vega

Effects of proprioceptive training program on core stability and center of gravity control in sprinters.

Abstract Romero-Franco N, Martínez-López EJ, Lomas-Vega R, Hita-Contreras F, and Martínez-Amat A. Effects of proprioceptive training program on core stability and center of gravity control in sprinters. J Strength Cond Res 26(8): 2071–2077, 2012—The purpose of this study was to determinate the effect of a 6-week specific-sprinter proprioceptive training program on core stability and gravity center control in sprinters. Thirty-three athletes (age = 21.82 ± 4.84 years, height = 1.76 ± 0.07 m, weight = 67.82 ± 08.04 kg, body mass index = 21.89 ± 2.37 kg·m−2) from sprint disciplines were divided into a control (n = 17) and experimental (n = 16) groups. A 30-minute proprioceptive training program was included in the experimental group training sessions, and it was performed for 6 weeks, 3 times each week. This program included 5 exercises with the BOSU and Swiss ball as unstable training tools that were designed to reproduce different moments of the technique of a sprint race. Stability with eyes open (EO) and eyes closed, postural stability, and gravity center control were assessed before and after the training program. Analyses of covariance (&agr; = 0.05) revealed significant differences in stability in the medial-lateral plane with EO, gravity center control in the right direction and gravity center control in the back direction after the exercise intervention in the experimental athletes. Nevertheless, no other significant differences were demonstrated. A sprinter-specific proprioceptive training program provided postural stability with EO and gravity center control measures improvements, although it is not clear if the effect of training would transfer to the general population.

Changes in Biochemical Markers of Pain Perception and Stress Response After Spinal Manipulation

STUDY DESIGN Controlled, repeated-measures, single-blind randomized study. OBJECTIVES To determine the effect of cervical or thoracic manipulation on neurotensin, oxytocin, orexin A, and cortisol levels. BACKGROUND Previous studies have researched the effect of spinal manipulation on pain modulation and/or range of movement. However, there is little knowledge of the biochemical process that supports the antinociceptive effect of spinal manipulation. METHODS Thirty asymptomatic subjects were randomly divided into 3 groups: cervical manipulation (n = 10), thoracic manipulation (n = 10), and nonmanipulation (control) (n = 10). Blood samples were extracted before, immediately after, and 2 hours after each intervention. Neurotensin, oxytocin, and orexin A were determined in plasma using enzyme-linked immuno assay. Cortisol was measured by microparticulate enzyme immuno assay in serum samples. RESULTS Immediately after the intervention, significantly higher values of neurotensin (P<.05) and oxytocin (P<.001) levels were observed with both cervical and thoracic manipulation, whereas cortisol concentration was increased only in the cervical manipulation group (P<.05). No changes were detected for orexin A levels. Two hours after the intervention, no significant differences were observed in between-group analysis. CONCLUSION The mechanical stimulus provided by spinal manipulation triggers an increase in neurotensin, oxytocin, and cortisol blood levels. Data suggest that the initial capability of the tissues to tolerate mechanical deformation affects the capacity of these tissues to produce an induction of neuropeptide expression. J

Cross-cultural adaptation and validation of the Falls Efficacy Scale International in Spanish postmenopausal women.

ObjectiveFalls are a serious public health problem and one of the most important concerns for older people. The risk of falling is dramatically increased in osteoporotic postmenopausal women. The Falls Efficacy Scale International (FES-I) is a reliable and validated questionnaire that can assess the fear of falling. Our objective is to develop the FES-I cross-cultural adaptation to the Spanish postmenopausal population. MethodsFES-I was translated into Spanish language. One hundred postmenopausal women (50-65 years old) completed the FES-I and the 36-item Short-Form Health Survey (SF-36) questionnaire. Content validity was determined by a group of experts and participants. FES-I internal consistency and test-retest reliability were analyzed. Exploratory factor analysis was used to assess construct validity. Criterion validity has been evaluated using the Spearman correlation coefficient with the 36-item Short-Form Health Survey. ResultsFES-I has an excellent test-retest reliability (intraclass correlation coefficient, 0.972; P < 0.001) and good internal consistency (Cronbach &agr; = 0.940). Factor analysis showed one unifactorial structure with two underlying dimensions related to less or more demanding physical activities. FES-I global score showed a negative correlation with the two SF-36 summary measures (P < 0.001). ConclusionsThe Spanish version of FES-I showed high reliability and validity in the adaptation for the Spanish postmenopausal population. Future studies are required to assess the sensitivity to change and to predict the risk of future falling.

The Spanish lower extremity functional scale: a reliable, valid and responsive questionnaire to assess musculoskeletal disorders in the lower extremity.

Abstract Purpose: The Lower Extremity Functional Scale (LEFS) is a widely used questionnaire to evaluate the functional impairment of a patient with a disorder of one or both lower extremities. It also can be used to monitor the patient over time and to evaluate the effectiveness of an intervention. Nevertheless there is no Spanish version of the LEFS, so the aim of this study was the translation and cross-cultural adaption of the Spanish version of the LEFS and to evaluate its psychometrics properties. Methods: The questionnaire was cross cultural adapted into Spanish. The psychometric properties tested in the Spanish version of the LEFS were: internal consistency, test–retest reliability, constructs validity, discriminative validity, responsiveness, concurrent validity and floor and ceiling effects in 132 participants seeking for treatment due to lower extremity dysfunction. Results: The Spanish version of the LEFS had high internal consistency (Cronbach’s α = 0.989), test–retest reliability (ICC = 0.998, 95% CI: 0.996–0.999) and presented a high correlation with the SF-36 (36-Item Short-Form Health Survey) especially with the physical function and pain subscales. The construct validity showed a single factor that account for 84.95% of the variance. The standard error of measurement of the Spanish version of the LEFS was 0.88 scale points (95% CI) and the minimal detectable change was 2.18 scale points (95% CI). The sample, collected from five Spanish physical therapy centers, was divided in groups (acute, sub-acute and chronic subjects). Within group changes showed a significant improvement on the LEFS score (p < 0.001) and effect sizes were large in all conditions. The LEFS allowed to distingue between acute and not acute conditions; for this criterion ROC curve was performed at baseline (area under the curve [AUC] = 0.95). There was no floor or ceiling effects. Conclusions: The Spanish version of the LEFS has been shown to be a valid and reliable tool to assess musculoskeletal dysfunction in the lower extremity that could be used with Spanish speaker population. Implications for Rehabilitation Cross-cultural adaptation of a self-reported questionnaire to evaluate musculoskeletal lower extremity disorders in the Spanish population. To provide Spanish clinicians and physiotherapists a useful tool to assess the lower extremity function. To provide Spanish researchers a valid tool for research on lower extremity function: patient’s improvement due to treatment, compare results obtained between populations, treatment.

Predictive value of stabilometry and fear of falling on falls in postmenopausal women.

Abstract Objectives Falls are one of the leading causes of fractures and impaired quality of life in the elderly, and they are related to balance deficit and to fear of falls. The purpose of our study is to evaluate predictors of falls in the 50–65-year-old postmenopausal population. Methods A prospective cohort study was conducted on 96 postmenopausal women. Fear of falling and postural stability were assessed by using the FES-I (Falls Efficacy Scale-International) and a force platform, respectively. Fall frequency was determined in the 12-month follow-up study period. Multivariate logistic regression was used to identify predictive factors of falls. Results Fear of falls, the FES-I scale and four stabilometric parameters, specifically under eyes-closed condition, were significantly higher in the group of fallers. The root mean square amplitude in the medial–lateral direction with eyes closed (RMSXec) (odds ratio 5.1, 95% confidence interval (CI) 1.6–15.5, p = 0.004) and FES-I (odds ratio 3.4, 95% CI 1.1–10.5, p = 0.026) were the best independent predictive factors of the risk of falling. Conclusions RMSXec > 0.133 was the best predictive factor for falls in our group of 50–65-year-old postmenopausal women studied, and a FES-I score > 20 could predict falls in this population.

Development and morphogenesis of human wrist joint during embryonic and early fetal period.

The development of the human wrist joint has been studied widely, with the main focus on carpal chondrogenesis, ligaments and triangular fibrocartilage. However, there are some discrepancies concerning the origin and morphogenetic time‐table of these structures, including nerves, muscles and vascular elements. For this study we used serial sections of 57 human embryonic (n = 30) and fetal (n = 27) specimens from O’Rahilly stages 17–23 and 9–14 weeks, respectively. The following phases in carpal morphogenesis have been established: undifferentiated mesenchyme (stage 17), condensated mesenchyme (stages 18 and 19), pre‐chondrogenic (stages 19 and 20) and chondrogenic (stages 21 and over). Carpal chondrification and osteogenic processes are similar, starting with capitate and hamate (stage 19) and ending with pisiform (stage 22). In week 14, a vascular bud penetrates into the lunate cartilaginous mold, early sign of the osteogenic process that will be completed after birth. In stage 18, median, ulnar and radial nerves and thenar eminence appear in the hand plate. In stage 21, there are indications of the interosseous muscles, and in stage 22 flexor digitorum superficialis, flexor digitorum profundus and lumbrical muscles, transverse carpal ligament and collateral ligaments emerge. In stage 23, the articular disc, radiocarpal and ulnocarpal ligaments and deep palmar arterial arch become visible. Radiate carpal and interosseous ligaments appear in week 9, and in week 10, dorsal radiocarpal ligament and articular capsule are evident. Finally, synovial membrane is observed in week 13. We have performed a complete analysis of the morphogenesis of the structures of the human wrist joint. Our results present new data on nervous and arterial elements and provide the basis for further investigations on anatomical pathology, comparative morphology and evolutionary anthropology.

Tai Chi for Risk of Falls. A Meta‐analysis

To analyze the effectiveness of tai chi for falls prevention.

The Effect of Tai Chi on Reducing the Risk of Falling: A Systematic Review and Meta-Analysis

Tai Chi has frequently been used as a preventive measure against falling in at-risk populations. However, studies have yielded contradictory results, and literature reviews have considered only a small number of trials and have not addressed some key aspects, such as sources of heterogeneity and publication bias. This study includes 13 controlled trials published before June 2015 that analyzed the effectiveness of Tai Chi in fall prevention in populations of frail and at-risk adults. The effect measure used in this meta-analysis was absolute risk reduction (ARR) with a 95% confidence interval (CI). According to our findings, practice of Tai Chi significantly prevents the risk of falling (ARR, [Formula: see text]; 95% CI: [Formula: see text], [Formula: see text]). The heterogeneity of results across the trials was low, with a reduced risk of publication bias, and no significant effect differences were observed between studies comparing Tai Chi with other interventions or non-treatment. We therefore conclude that Tai Chi is more effective than other measures, or no intervention, for fall prevention in at-risk populations. Further research is warranted to analyze the consequences of falls and to study the episodes rather than the cases of falls.

The Activities-specific Balance Confidence scale: reliability and validity in Spanish patients with vestibular disorders

Abstract Purpose: To examine the reliability and validity of the Spanish version of the Activities-specific Balance Confidence scale (ABC-S), and its ability to discriminate between patients with and without a history of falls among a Spanish population with vestibular disorders. Method: A total of 84 participants completed the ABC-S. Internal consistency, test–retest reliability and construct validity (exploratory factor analysis) were analysed. Concurrent validity was evaluated using the 12-item Short Form Health Survey (SF-12) and the Dizziness Handicap Inventory (DHI). To determine the accuracy of the ABC total score in discriminating patients with and without a history of falls, a receiver operating characteristic (ROC) curve analysis was performed. Results: The ABC-S showed excellent internal consistency (Cronbach’s α = 0.916) and substantial test–retest reliability (ICC = 0.86, 95% CI: 0.74–0.93), with standard error and minimal detectable change values of 8.64 and 16.94, respectively. Factor analyses suggested a three-factor structure (explained variance was 62.24%). The ABC total score significantly correlated with the physical component summary score of the SF-12 and with the DHI-P, DHI-E, DHI-F and DHI total scores (p < 0.001). The ABC-S was significantly able to discriminate between participants with and without a history of falls (p < 0.006). Conclusions: The ABC-S is a valid and reliable instrument, suitable to assess balance confidence in Spanish patients with vestibular disorders. Implications for Rehabilitation The Spanish version of the ABC scale is a valid and reliable measure of balance confidence in patients with vestibular disorders. In persons with vestibular disorders, the Spanish version of the ABC scale has shown the ability to discriminate between patients with and without a history of falls in the last year.

Tissue Damage Markers after a Spinal Manipulation in Healthy Subjects: A Preliminary Report of a Randomized Controlled Trial

Spinal manipulation (SM) is a manual therapy technique frequently applied to treat musculoskeletal disorders because of its analgesic effects. It is defined by a manual procedure involving a directed impulse to move a joint past its physiologic range of movement (ROM). In this sense, to exceed the physiologic ROM of a joint could trigger tissue damage, which might represent an adverse effect associated with spinal manipulation. The present work tries to explore the presence of tissue damage associated with SM through the damage markers analysis. Thirty healthy subjects recruited at the University of Jaén were submitted to a placebo SM (control group; n = 10), a single lower cervical manipulation (cervical group; n = 10), and a thoracic manipulation (n = 10). Before the intervention, blood samples were extracted and centrifuged to obtain plasma and serum. The procedure was repeated right after the intervention and two hours after the intervention. Tissue damage markers creatine phosphokinase (CPK), lactate dehydrogenase (LDH), C-reactive protein (CRP), troponin-I, myoglobin, neuron-specific enolase (NSE), and aldolase were determined in samples. Statistical analysis was performed through a 3 × 3 mixed-model ANOVA. Neither cervical manipulation nor thoracic manipulation did produce significant changes in the CPK, LDH, CRP, troponin-I, myoglobin, NSE, or aldolase blood levels. Our data suggest that the mechanical strain produced by SM seems to be innocuous to the joints and surrounding tissues in healthy subjects.