Efficacy of physiotherapy treatment in medium and long term in adults with fibromyalgia: an umbrella of systematic reviews.

OBJECTIVES: To summarise the available evidence and assess the effectiveness of medium and long-term physiotherapy treatment in adults with fibromyalgia (FM). METHODS: This systematic review was registered in PROSPERO: CRD42023388356. The databases searched were MEDLINE, PEDro, Scopus, Cinhal, LatinIndex, and Cochrane, using the following keywords: "fibromyalgia", "physiotherapy", "treatment", "therapeutic exercise", "TENS", "laser therapy" and "manual therapy." The included articles analysed treatments with active or passive physiotherapy approaches in patients with FM. The variables included structural characteristics, such as: author, publication year, research question, and main outcome variables. The data on the findings of the articles comprised the following aspects: number of participants, intervention, follow-up, results, and principal conclusions. RESULTS: Thirty-three articles were analysed, with an overall PRISMA score of 18.63±3.36. The active treatment methods analysed were: movement and body awareness therapies (stretching, tai chi, yoga and Pilates); hydrotherapy; physical or aerobic exercise; and multidisciplinary therapy. The passive therapies analysed were: manual therapy; repetitive transcranial magnetic stimulation (rTMS); and other therapies (hyperbaric oxygen therapy, vibration therapy, virtual reality, transcutaneous electric nervous stimulation (TENS), pain neuroscience education, and acupuncture). Evidence was found on the positive effect of physiotherapy treatment on the signs and symptoms of fibromyalgia, such as pain, impairment of physical capacity and worse quality of life. CONCLUSIONS: The effectiveness of the active and passive therapies analysed in the management of the symptoms and signs of the disease was positive in most of the studies. However, more specific descriptions of the treatment protocol, frequency, intensity and treatment dose are required to reach a consensus, as well as primary studies for a more extended follow-up period to better evaluate long-term effects.

Questionnaires for the subjective evaluation of patients with fibromyalgia: a systematic review.

INTRODUCTION: The objective of this study was to identify and review the subjective assessment tools validated in patients with fibromyalgia, identifying their most significant structural characteristics, as well as the psychometric characteristics analyzed in each of the identified instruments. EVIDENCE ACQUISITION: This systematic review was registered in PROSPERO with the following reference: CRD42022306878. It analyzed documents published until June 30, 2022, through the Medline, Pedro and Scopus, Dialnet, Cinahl and Latin Index databases. The keywords used were: 1) fibromyalgia; 2) assessment; 3) questionnaire; 4) reliability; 5) validity; 6) scale; and 7) validation study. Combined using the Boolean operators "AND" and "OR." The included articles were analyzed to extract: data on the structural characteristics of the questionnaires (including acronym, year of publication, number of items, sub-categories, time to complete the questionnaire, measurement range, cutoff score and cost) and psychometric characteristics of the selected questionnaires, including data on reliability (Cronbach's alpha and test-retest) and data on the validity of the questionnaires (content, construct and criterion validity). EVIDENCE SYNTHESIS: Twenty-two studies containing 16 questionnaires were analyzed. The quality and risk of bias assessment was performed following the COSMIN checklist. In general, the quality of the subjective assessment studies validated in the population with fibromyalgia was good, with the exception of 5 studies, which did not exceed 5 points out of 10. The first questionnaire analyzed was published in 1991, and the last in 2020; the number of items ranged from 3 to 60. The most measured subcategories are function, overall impact and symptoms; other studies also include sleep and cognition disturbances. Only 6 studies described the time to complete them. The most analyzed psychometric characteristics were reliability (analyzed by 13 questionnaires), validity (analyzed by 7) and error measures (provided by only 3 of them). CONCLUSIONS: There is a wide range of questionnaires specifically designed for patients with fibromyalgia that present good and/or excellent basic psychometric characteristics. The structural characteristics of the identified instruments were very heterogeneous, which makes it possible to select those that best adapt to the clinical/investigator scenario where the tool will be used.

Does Physical Exercise Enhance the Immune Response after Vaccination? A Systematic Review for Clinical Indications of COVID-19 Vaccine.

BACKGROUND: Stimulating protective immunity with vaccines appears to be the most promising option for providing widespread moderate to high protection against COVID-19 in people over the age of 18. Regular exercise improves the immune response, transmitting possible benefits against virus infections. The aim of this review is to study the effects of physical activity on vaccine injections, helping to develop new recommendations for COVID-19 vaccination campaigns. METHODS: A comprehensive review of the existing literature was undertaken using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The internal quality of the studies was assessed according to the Physiotherapy Evidence Database (PEDro) scale. The outcomes analyzed were antibody titer, the level of lymphocytes CD4, CD8, InterLeukin 6 (IL6), leukocytes level, the visual analogue scale (VAS) for overall pain rating, arm and forearm circumferences and volume of oxygen (VO2) peak. RESULTS: Fourteen articles were selected for the analysis. The majority of studies were randomized controlled trials (RCT) (n = 8) and controlled trials (CT) (n = 6). According to PEDro, the 'fair' category (n = 7) was the most represented, followed by 'good' (n = 6) and 'excellent' (n = 1). Physical training showed a positive effect on antibody titers of the vaccine; yet, different variables seem to influence antibody titers: higher new vs. old antigen in the vaccine, higher in younger vs. older individuals, and higher in females vs. males. After exercise, when analyzing variables of direct response to the vaccine, such as the amount of CD4, IL-6 and leukocytes, higher levels were observed in the patients who performed physical exercise compared to the control group. In the same way, better results were observed in physiological variables such as VO2 and limb circumferences, or subjective variables such as pain, which showed better results than the control group. CONCLUSIONS: The immune response (antibody titers) depends on age, gender and the intensity of physical activity: long-term protocols at moderate intensity are the most recommended. All of these aspects also have to be carefully considered for the COVID-19 vaccination.

Spanish Cross-Cultural Adaptation and Validation of the Oslo Sports Trauma Research Centre (OSTRC) Overuse Injury Questionnaire in Handball Players.

OBJECTIVES: The aim of this study was the cultural adaptation, Spanish translation and validation of the Oslo Sports Trauma Research Centre (OSTRC) Overuse Injury Questionnaire in an adult population. DESIGN: In this study, a cross-sectional design was used. METHODS: This study was divided into two phases: (1) cross-cultural adaptation of the original version of the OSTRC to a Spanish version (OSTRC-Sp) and (2) analysis of the psychometric properties of the OSTRC-Sp. A total of 427 handball players of both sexes and over 18 years of age participated in the study. RESULTS: The translated version of the questionnaire showed a very high internal consistency (Cronbach's α = 0.954), while the subscales showed an internal consistency between 0.832 and 0.961, with the endmost values being for shoulder and low back pain, respectively. On the other hand, when analysing item responses, the OSTRC-Sp showed ICC values ranging from 0.844 to 0.956, the former being for the first back question (back_1), and the latter for the fourth shoulder question (shoulder_4), in line with most published versions. CONCLUSION: The Spanish version of the OSTRC is a reliable and valid tool that can be used by researchers and clinicians in a Spanish-speaking population with musculoskeletal disorders.

Validity of the Baiobit Inertial Measurements Unit for the Assessment of Vertical Double- and Single-Leg Countermovement Jumps in Athletes.

Jump tests are simple, quick to execute, and considered the most reliable tool to measure lower extremities power and explosiveness in athletes. Wearable inertial sensors allow the assessment of jumping performance on any surface. The validity of inertial sensors measurements is a pivotal prerequisite to reliably implement their utilization in the clinical practice. Twenty-seven athletes (20 M/7 F, age: 27 ± 7 years old) performed five double-leg countermovement jumps (CMJs) and three single-leg CMJs per side with their hands on their hips. Jump height was measured/computed simultaneously with the optoelectronic system, force platforms, and the Baiobit inertial sensor system. The athletes completed the international physical activity questionnaire (IPAQ). When comparing the methods (Baiobit vs. force platforms), a non-statistically significant bias of 1.8 cm was found for two-leg CMJs and -0.6 cm for single-leg CMJs. The intraclass correlation coefficients (ICCs) was "excellent" for double-leg CMJs (ICC = 0.92, 95% CI = 0.89-0.94) and "good" for single-leg CMJs (ICC = 0.89, 95% CI = 0.85-0.91). When comparing the methods (Baiobit vs. force platforms + optoelectronic system), a non-statistically significant bias of -0.9 cm was found for two-leg CMJs and -1.2 cm for single-leg CMJs. The intraclass correlation coefficient (ICC) was "good" for both double-leg CMJs (ICC = 0.80, 95% CI = 0.73-0.85) and for single-leg CMJs (ICC = 0.86, 95% CI = 0.80-0.89). Baiobit tends to overestimate double- and single-leg CMJ height measurements; however, it can be recommended in the world of rehabilitation and sport analysis.

Psychometric analysis of the questionnaires for the assessment of upper limbs available in their Italian version: a systematic review of the structural and psychometric characteristics.

INTRODUCTION: There is no systematic review that analyzes the psychometric properties of questionnaires in Italian. Previous studies have analyzed the psychometric characteristics of instruments for the measurement of pathologies of upper limbs and their joints in different languages. The aim of the present study was to analyze the psychometric properties of the questionnaires published in Italian for the evaluation of the entire upper limb or some of its specific regions and related dysfunctions. EVIDENCE ACQUISITION: For the development of this systematic review, the following databases were used: PubMed, Scopus, Cochrane, Dialnet, Cinahl, Embase and PEDro. The selection criteria used in this study were: studies of transcultural adaptation to Italian of questionnaires oriented to the evaluation of upper limbs or any of their structures (specifically shoulder, elbow and wrist/hand), and contribution of psychometric variables of the questionnaire in its Italian version. EVIDENCE SYNTHESIS: After reading the titles and applying the inclusion and exclusion criteria to the complete documents, 16 documents were selected: 3 for the upper limb, 8 for the shoulder, 1 for the elbow and 4 for the wrist and hand. The cross-sectional psychometric variables show levels between good and excellent in all the questionnaires. Longitudinal psychometric variables had not been calculated in the vast majority of the analyzed questionnaires. CONCLUSIONS: Italian versions of the questionnaires show good basic structural and psychometric characteristics for the evaluation of patients with musculoskeletal disorders of the upper limb and its joints (shoulder, elbow and wrist/hand).

Questionnaires for the evaluation of the cervical and lumbar spine in Italian language: a systematic review of the structural and psychometric characteristics.

INTRODUCTION: There has been an increase in the use of questionnaires as tools for the subjective evaluation of patients with neuro-musculoskeletal problems. The aim of this study was to analyze the psychometric properties of the questionnaires published in Italian for the evaluation of cervical and lumbar spine pain and related dysfunction. EVIDENCE ACQUISITION: Two blinded bibliographical searches were carried out on seven databases, regarding back, lumbar and/or cervical musculoskeletal problems. Both the structural characteristics and the psychometric aspects of each of the questionnaires were extracted from each of the selected articles. The structural characteristics were: full name, acronym, author and date of adaptation to the Italian language, what it measures, number of items, time to complete, the result scale, where the points are located and the cost. The psychometric aspects were: standard error of measurement (SEM), minimum detectable change (MDC), minimal clinically important difference (MCID), test-retest reliability, internal consistency, criterion validity, construct validity and sensitivity to changes. EVIDENCE SYNTHESIS: For the structural characteristics of the questionnaires identified for the valuation of the lumbar area, the number of items ranged between 10 and 24. Only two of the questionnaires presented specific categories, and the time to complete ranged between 5 and 7 minutes. The reliability of the questionnaires ranged between 0.869 and 0.961. None of the questionnaires calculated the inter-observer reliability. The internal consistency ranged between 0.82 and 0.90 for criterion validity. None of the questionnaires calculated sensitivity, SEM, MDC or MCID, with the exception of the Fear-Avoidance Beliefs Questionnaire, which showed a value of 12 on MDC. For the assessment of the cervical region, the number of items ranged from 6 to 20. Three of the questionnaires had sub-categories, and the time to complete them ranged between 2 and 5 minutes. The test-retest reliability ranged between 0.78 and 0.997. The internal consistency ranged between 0.842 and 0.942. CONCLUSIONS: The Italian versions of the questionnaires present good basic structural and psychometric characteristics for the evaluation of patients with back, lumbar and/or cervical musculoskeletal disorders. The analysis of the structural and psychometric characteristics of these questionnaires is fundamental to identify the best tools to use in research and in clinical practice.