Transcutaneous Tibial Nerve Stimulation for Primary Dysmenorrhea: A Protocol for a Randomized Controlled Trial.

Primary dysmenorrhea (PD) is a painful menstruation that can persist for the duration of a woman's fertile life. Non-steroidal anti-inflammatory drugs, hormonal therapy, physiotherapy techniques, etc., are the main treatments. The main objective of this study is to evaluate the effectiveness of transcutaneous posterior tibial nerve stimulation (TTNS) in PD patients. The study will consist of a single-blind randomized clinical trial, parallel-assigned with two arms. Women with PD (18-43 years) with regular menstrual cycles and at least 4 points in VAS will be randomly divided into experimental (TTNS) and placebo (simulated stimulation) groups during 12 treatment sessions (1 session/week) and several follow-ups: monthly during treatment and 1, 3 and 6 months after. Maximum and mean pain intensity, pain duration, pain severity, number of anti-inflammatory drugs, quality of life, sleep quality, overall improvement, treatment satisfaction and secondary effects will be measured once a month every 6 months and at 3 and 6 months. The Student's t-test for independent samples or the Mann-Whitney U test will be used. The literature shows effective physiotherapeutic techniques for PD in the short term, which do not act on causes and have limitations. The TTNS technique can be used in transcutaneous and percutaneous modalities, with similar effectiveness, but the transcutaneous causes less discomfort. TTNS modulates pain, and long-term benefits could be achieved at low cost and without patient discomfort.

Quality of Life and Side Effects Management in Cancer Treatment-A Cross Sectional Study.

Cancer disease is a world problem which is increasing in its prevalence. Oncology patients have a multitude of symptoms derived from the treatments and from the disease itself that affect their quality of life to a greater or lesser extent. The aim of this study has been to discover the physical and psychological symptoms related to chemotherapy treatment in Spanish cancer patients in order to improve their quality of life. Symptoms from the previous week were taken into account and the Memorial Symptom Assessment Scale was used to measure the frequency, severity and associated distress of 32 symptoms. A total of 246 chemotherapy patients at the University Day Hospital in Salamanca completed the scale once while receiving chemotherapy treatment. A 95% confidence interval was considered. The most prevalent symptoms were a lack of energy (76.4%), anxiety (66.7%) and a dry mouth (60.6%). Lung cancer was the most prevalent cancer in men (26%) and breast cancer was the most prevalent cancer in women (72%). There is no consensus on which is the most prevalent symptom in this population and more studies will need to be carried out to determine the best treatment protocols. Symptom's prevalence knowledge could improve the patients' care to prevent or avoid complications and to improve the cancer patients' quality of life.

Effect of a lifestyle-integrated functional exercise (LiFE) group intervention (sLiFE) to falls prevention in non-institutionalized older adults. Protocol of a randomised clinical trial.

Introduction: Personalized programs of integrated strength and balance activities have been shown their effectiveness in falls reduction in the older adults. Objective: To measure whether a group intervention with the strength and balance principles of the sLiFE program is more effective than standard health advice in reducing the incidence of falls. Methods: The study will comprise 650 participants with more than 65 years who live at home, observing established inclusion and exclusion criteria. Participants will be randomly assigned in two groups: group intervention (n = 325) and standard health advice (n = 325). The intervention group will follow the balance and strength activities described in the LiFE program manual. The group intervention will be carried out in groups of 12-14 and will consist of seven one-hour sessions over 12 weeks in health centres. Incidence of falls and quality of life will be assessed as primary outcome variables. Fear of falling and exercise adherence will be analysed as secondary outcome variables. Discussion: Physical activity has been put forward as an effective treatment technique for these patients; however, long-term adherence to these programs remains a challenge. Group interventions could reduce dropout rates. Conclusion: Falls represent a major health problem globally due to the disability they cause in older people. Prevention would help reduce not only their incidence but also the health costs derived from their treatment. Group intervention helps clinicians to save resources and time, being able to attend more people with the same quality of care. Clinical trial registration: https://clinicaltrials.gov/study/NCT05912088?distance=50&term=NCT05912088&rank=1, identifier NCT05912088.

Reliability and Validity of the Spanish Version of the Memorial Symptom Assessment Scale in Oncology Patients.

CONTEXT: Memorial Symptom Assessment Scale (MSAS) is a multidimensional tool developed to evaluate frequency, severity, and distress of common symptoms present in cancer patients. OBJECTIVE: To translate the original English version of MSAS and prove the reliability and validity of the Spanish version. METHODS: MSAS scale was translated into Spanish and administered to 246 cancer patients aged between 18 and 85 years. They attended the Day Hospital to receive chemotherapy. European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30 and Rotterdam Symptom Checklist were used to test criterion validity. RESULTS: TOTAL MSAS, Physical Symptom Subscale (PHYS), Psychological Symptom Subscale (PSYCH), and Global Distress Index (GDI) reported high internal consistency: 0.891, 0.801, 0.825, 0.813, respectively. Exploratory factor analysis identified two-factors structure and confirmatory factor analysis showed good adjustment rates. The emotional functioning subscale of European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30 highly correlated with PSYCH (r = -0.868; P < 0.001) and GDI (r = -0.810; P < 0.001), whereas social functioning subscale correlated with PSYCH (r = -0.704; P < 0.001) and GDI (r = -0.624; P < 0.001). The PHYS of Rotterdam Symptom Checklist correlated with PHYS (r = 0.876; P < 0.001) and the PSYCH with PSYCH (r = 0.872; P < 0.001). CONCLUSION: The Spanish version of MSAS was determined to be a valid and reliable scale in cancer patients.