[Efficacy of Physiotherapy Interventions on the Respiratory Musculature Through Respiratory Training Techniques in Post-operative Lung Transplant Recipients: Systematic Review]. / Eficacia de las intervenciones fisioterápicas sobre la musculatura respiratoria mediante técnicas de entrenamiento respiratorio en el postoperatorio de trasplantados pulmonares: una revisión sistemática.

Introduction: Respiratory muscles are a limiter of exercise capacity in lung transplant patients. It is necessary to know the effectiveness of specific respiratory muscle training techniques carried out in the management of adult lung transplant patients in the postoperative period. Methodology: A systematic review of clinical trials was carried out, which included adult lung transplant patients undergoing post-transplant respiratory training. A search was carried out in the databases PubMed/Medline, EMBASE, Scopus, Web of Science, Cochrane Library between January 2012 and September 2023, using the terms: "breathing exercise", "respiratory muscle training", "inspiratory muscle training", "respiratory exercise", "pulmonary rehabilitation", "lung rehabilitation"; in combination with "lung transplantation", "lung transplant", "posttransplant lung". No language limit. Results: Eleven trials were included with a total of 639 patients analyzed. Most training programs begin upon hospital discharge (more than one month post-transplant), few do so early (Intensive Care Unit). The duration varies from 1-12 months post-transplant. The interventions were based on aerobic training and peripheral muscle strength. Some of them included breathing exercises and chest expansions. The most used outcome variable was submaximal exercise capacity measured with the 6-minute walk test. Conclusions: Training the respiratory muscles of the adult transplant patient favors the improvement of exercise capacity and quality of life. Aerobic training, as well as strength training of the rest of the peripheral muscles, contribute to the improvement of respiratory muscles.

Efficacy of the myofascial approach as a manual therapy technique in patients with clinical anxiety: A randomized controlled clinical trial.

BACKGROUND: To analyze the efficacy of the myofascial approach in patients with clinical anxiety and to study its relationship with associated symptoms. METHODS: Randomized placebo-controlled clinical trial. Thirty-six adult patients with clinical anxiety were randomized to receive the myofascial treatment (n = 18) or placebo (n = 18). The patients and the evaluators were blinded to this assignation. The treatment consisted of four myofascial sessions of 40 min each for four weeks. The placebo intervention consisted of four sessions of simulated myofascial intervention of the same duration and frequency as the treatment. Follow-up was at one, three and six months. The primary outcome was clinical anxiety measured using the STAI (State-Trait Anxiety Inventory). Secondary outcomes were central sensitization, general health, somatization, depression, and pain. RESULTS: There were significant differences in the behavior of the groups over time for clinical anxiety (STAI Trait-Anxiety) (p < 0.001), central sensitization (p = 0.005) and somatization (p = 0.008) in favor of the myofascial group, with a large effect size for anxiety and a medium effect size for central sensitization and somatization. Regarding clinical anxiety, after the intervention a mean difference was observed with respect to the baseline of 19.98 points in the myofascial group (p < 0.001) and 5.95 in the placebo group (p = 0.22). The intention-to-treat principle was used. There were no adverse events or side effects in either group. CONCLUSIONS: The myofascial approach is effective in improving anxiety levels and associated central sensitization processes in patients with clinical anxiety and this improvement is maintained over time. CLINICAL TRIAL REGISTRATION: NCT04826302.

Imagined Timed Up and Go test (iTUG) in people with Parkinson's Disease: test-retest reliability and validity.

PURPOSE: To determine the test-retest reliability and validity of the Imagined Timed Up and Go Test (iTUG) as a Motor Imagery measure of temporal accuracy in people with Parkinson's Disease (PD). MATERIALS AND METHODS: A descriptive study was conducted following the GRRAS recommendations. Thirty-two people with idiopathic, mild to moderate PD (Hoehn and Yahr I-III), without cognitive impairment (MMSE ≥ 24), were assessed twice (7-15 days apart) with the iTUG. The absolute unadjusted difference in seconds, and the absolute adjusted difference as percentage of estimation error, between real and imagined TUG times, were calculated as outcome measures. Test-retest reliability was assessed using a two-way mixed-effects model of the ICC. Construct validity was tested with the Imagined Box and Blocks Test (iBBT) and convergent validity with clinical characteristics of PD, using the Spearman's rank correlation coefficient. RESULTS: The ICC for the unadjusted and adjusted measures of the iTUG was ICC = 0.61 and ICC = 0.55, respectively. Correlations between iTUG and iBBT were not statistically significant. The iTUG was partially correlated to clinical characteristics of PD. CONCLUSIONS: Test-retest reliability of the iTUG was moderate. Construct validity between iTUG and iBBT was poor, so caution should be taken when using them concurrently to assess imagery's temporal accuracy.

In people with Parkinson's Disease (PD), the absolute unadjusted difference (in seconds) and the absolute adjusted difference (as a percentage of estimation error) of the Imagined Timed Up and Go test (iTUG) were moderately reliable.iTUG and Imagined Box and Blocks Test (iBBT) measures were not statistically correlated. Therefore, temporal accuracy measures of Motor Imagery are highly task-dependant and thus their construct validity is poor.Correlations between the adjusted and unadjusted measures of the iTUG and the majority of clinical variables of PD were not statistically significant. Statistically significant correlations were only found between the unadjusted difference and MDS-UPDRS Part III, Schwab and England, and Berg Balance scales, as well as the adjusted difference and disease duration.

Preoperative respiratory therapy in patients undergoing surgery for lung cancer: A randomized controlled trial.

BACKGROUND: A preoperative respiratory therapy treatment was performed to analyze the effectiveness, with respect to postoperative air leak and pain, in patients undergoing surgery for lung cancer. OBJECTIVES: To analyze air leakage and postoperative pain. MATERIAL AND METHODS: Seventy one patients were studied, with a mean age of 62.58 years. Descriptive variables of gender, carcinogenic pathology, type of surgical incision and lung resection, use of glue and endostapler, and presence of adhesions were analyzed. Likewise, analysis of the quantitative variables of age, body mass index and forced expiratory volume in 1 s Two homogeneous groups resulted. Differentiated, experimental group (EG) that performed preoperative respiratory therapy and control group (CG). RESULTS: There were statistically significant differences in favor of the EG with respect to postoperative air leak on days 1-2 during the performance of physiotherapy techniques, the food and during the performance of the exercises autonomously. Furthermore, differences in air leakage were observed on days 2-4 during gait. The number of patients decreased to a greater extent in the EG. Regarding pain, there were statistically significant differences in the sample on days 1-4, with greater intensity of pain in the CG and after doing physiotherapy every day except the second. CONCLUSIONS: Preoperative respiratory therapy in patients undergoing surgery for lung cancer was effective in reducing the number of patients who presented postoperative air leak and reducing pain in the EG.

Dynamic pedobarographic classification of idiopathic toe-walkers for therapeutical indication / Clasificación baropodométrica dinámica de los andadores de puntillas para la indicación terapéutica

Idiopathic toe-walkers (ITWs) pedobarographic analysis has not been described yet nor its possible relationship with orthopedical and developmental characteristics. The objective of this research is to develop a dynamic pedobarographic classification of ITWs to propose a specific therapeutical approach. Through an observational study, 56 ITWs aged 3-6 years were classified by their initial foot contact; differences between idiopatic toe-walking (ITW) types and with respect to 40 control children were calculated by means of ANOVA and Student t-tests. The results show that the three ITW types displayed different step models for pressure and impulse distribution and also for temporal development (p<.05). They also showed different orthopedic and developmental characteristics (p<.05). As a whole, they demonstrated different severity levels, which suggest different therapeutical indications. This study confirms the convenience of a specific orthopedic, developmental, and gait assessment in ITW to clarify therapeutical indication

El análisis baropodométrico de la marcha de los andadores de puntillas (AP) no ha sido aún descrito en la literatura, ni tampoco su posible relación con sus características ortopédicas y neuromadurativas. El objetivo de este trabajo es desarrollar una clasificación baropodométrica dinámica de los AP para proponer un abordaje terapéutico específico. En un estudio observacional, 56 AP de 3 a 6 años han sido clasificados por su contacto inicial del pie, calculándose las diferencias entre los diferentes tipos de AP y con respecto a 40 niños que conformaron el grupo control, mediante los tests ANOVA y t de Student. Los resultados demostraron que los tres tipos de AP tenían diferentes modelos de paso en cuanto a la distribución de presiones e impulsos y también en su desarrollo temporal (p<.05). También se encontraron diferencias significativas en sus características ortopédicas y neuromadurativas (p<.05). En conjunto, los tres grupos de AP demostraron diferentes niveles de severidad que sugieren la indicación de abordajes terapéuticos diversos. Este estudio confirma la necesidad de una valoración específica de la marcha ortopédica y neuromadurativa en los AP para clarificar la indicación terapéutica

The Bobath Concept in Walking Activity in Chronic Stroke Measured Through the International Classification of Functioning, Disability and Health.

PURPOSE: The aim of this study is to evaluate the effectiveness of a rehabilitation programme based on the Bobath concept in order to improve walking activity in patients with chronic stroke and to show the usefulness of the International Classification of Functioning, Disability and Health (ICF) as a tool for gathering functioning information. METHODS: This study is a repeated measures study. The setting of this study is an outpatient neurological rehabilitation centre based on a multidisciplinary approach. Twenty-four participants suffering from chronic stroke (>1 year and a half and <5 years post-stroke) and mean age of 65.58 (standard deviation 10.73) were the participants of the study. Multidisciplinary approach based on the Bobath concept principles with three weekly individual physiotherapy sessions of 45 min each over a 6-month period was the intervention for this study. The measures used were Modified Emory Functional Ambulation Profile, 10-m walk test, 6-min walk test, muscle strength testing and subsequent codification of these results into ICF qualifiers. RESULTS: The results of the study showed significant improvement in activities of walking long distances, on different surfaces and around obstacles. There was no significant improvement in the activity of walking short distances or for muscle power functions. CONCLUSION: A rehabilitation programme based on the Bobath Concept improved walking activities in people with chronic stroke. For this intervention, the use of the ICF qualifiers was sensitive in perceiving post-treatment changes.