Chronic Musculoskeletal Pain and Central Sensitization-Related Symptoms in Chilean Victims of Political Violence During the 1973 to 1990 Dictatorship.

People who suffer political violence (PV) are at risk of developing mental illness, chronic noncommunicable diseases, chronic pain, and decreased life expectancy. However, these indicators have been studied primarily in war veterans and refugees. The objective of this study was to estimate the prevalence of chronic musculoskeletal pain (CMP) and central sensitization-related symptoms (CSRS) in Chilean victims of PV during the 1973 to 1990 dictatorship. A cross-sectional observational multicenter study was conducted. Three hundred twenty-five people from six centers of a Ministry of Health of Chile program participated. The presence of CMP was determined by a history of pain ≥3 months, and CSRS was determined using the central sensitization inventory. About 69.23% of the sample had CMP (76.85% of females and 56.56% of males). About 60% of people with CMP showed a high level of CSRS severity (66.67% females and 44.93% males). Females presented significantly higher proportions of CMP (p < .001), and there was an association between CSRS severity and being female (p = .004). Chilean victims of PV during the 1973 to 1990 dictatorship presented a high prevalence of CMP and high-level CSRS severity. Both conditions affected females more than males. Future studies are needed to further delve into these variables' behavior and their influence on the quality of life in this population.

Effects of exergames on rehabilitation outcomes in patients with osteoarthritis. A systematic review.

PURPOSE: To analyze the effects of exergames on rehabilitation outcomes in osteoarthritis (OA) patients. MATERIALS AND METHODS: A systematic review was reported according to the PRISMA statement. Randomized controlled trials (RCTs) were searched in Pubmed, Scopus, WoS, CINAHL, and PEDro (inception to November 2023). Studies that applied non-immersive exergames and assessed physical, functional, cognitive, pain, and psychosocial outcomes were included. Comparisons were other exercise modalities and non-intervention. Methodological quality was assessed with PEDro scale, and risk of bias (RoB) was assessed with Cochrane RoB-2 tool. RESULTS: Eight studies were included (total of participants = 401). The mean PEDro score was 6.1, and seven studies had high RoB. Seven studies involved knee OA and one cervical OA. The most frequent duration for interventions was four weeks. Exergames were more effective than controls in at least one outcome in all studies. The outcomes for which exergames were most effective were functional disability, postural balance, muscle strength, proprioception, gait, range of motion, pain, quality of life, depression, and kinesiophobia. CONCLUSION: Non-immersive exergames constitute an effective strategy for optimizing several relevant outcomes in rehabilitation. However, more RCTs with high methodological quality are required to deepen the knowledge about the multidimensional effects of exergames in OA patients.

Osteoarthritis (OA) is one of the leading causes of disability, involving high health costs and a public health problem.Physical exercise has recently been recognized as a first-line treatment in OA to reduce symptomatology and to improve or maintain physical functioning and quality of life.Non-immersive exergames are a safe therapeutic strategy to improve functional disability, postural balance, muscle strength, proprioception, gait performance, range of motion, and pain in OA patients.Similarly, non-immersive virtual reality strategies contribute to the improvement of depression, kinesiophobia, and quality of life in people with OA.

Effect of strength training on knee proprioception in patients with knee osteoarthritis: A systematic review and meta-analysis.

Proprioception is significantly impaired in knee osteoarthritis (KOA), contributing to reduced functionality. Strength training (ST) is essential in KOA by improving muscle strength, although it may also be effective in improving proprioception. The purpose was to determine the effect of ST on knee proprioception in KOA patients. Pubmed, CINAHL, Scopus, WOS, and PEDro were searched for randomized controlled trials (RCTs) (inception to March 2023). Comparisons for ST were physical exercise different from ST, non-exercise-based interventions, and no intervention. Methodological quality was assessed using the PEDro scale, and risk of bias (RoB) using the Cochrane tool. Meta-analyses were performed by comparison groups using the standardized mean difference (SMD) (Hedge's g) with random effects models, also considering subgroups by proprioception tests. Finally, six RCTs were included. The mean PEDro score was 6.3, and the highest proportion of biases corresponds to performance, selection, and detection. The meta-analysis indicated that only when compared with non-intervention, ST significantly improved knee proprioception for the joint position sense (JPS) (active + passive), JPS (passive), and threshold to detect passive motion (TTDPM) subgroups (g â€‹= â€‹-1.33 [-2.33, -0.32], g = â€‹-2.29 [-2.82, -1.75] and g â€‹= â€‹-2.40 [-4.23, -0.58], respectively). However, in the knee JPS (active) subgroup, ST was not significant (g â€‹= â€‹-0.72 [-1.84, 0.40]). In conclusion, ST improves knee proprioception compared to non-intervention. However, due to the paucity of studies and diversity of interventions, more evidence is needed to support the effectiveness of ST. Future RCTs may address the limitations of this review to advance knowledge about proprioceptive responses to ST and contribute to clinical practice.

Exercise-induced hypoalgesia in chronic neck pain: A narrative review.

Chronic neck pain (CNP) is a worldwide health problem with several risk factors. One of the most widely used treatments for managing this condition is therapeutic exercise, which could generate a response called exercise-induced hypoalgesia (EIH). There is no consensus on the best exercise modality to induce hypoalgesia. Therefore, this review aims to analyze and synthesize the state-of-the-art about the hypoalgesic effect of exercise in subjects with CNP. We included articles on EIH and CNP in patients older than 18 years, with pain for more than three months, where the EIH response was measured. Articles that studied CNP associated with comorbidities or measured the response to treatments other than exercise were excluded. The studies reviewed reported variable results. Exercise in healthy subjects has been shown to reduce indicators of pain sensitivity; however, in people with chronic pain, the response is variable. Some investigations reported adverse effects with increased pain intensity and decreased pain sensitivity, others found no clinical response, and some even reported EIH with decreased pain and increased sensitivity. EIH is an identifiable, stimulable, and helpful therapeutic response in people with pain. More research is still needed on subjects with CNP to clarify the protocols and therapeutic variables that facilitate the EIH phenomenon. In addition, it is necessary to deepen the knowledge of the intrinsic and extrinsic factors that influence EIH in people with CNP.

Complex regional pain syndrome type II localized to the index finger. A case report translating scientific evidence into clinical practice.

BACKGROUND: Complex regional pain syndrome type II (CRPS-II) is a rare condition associated with peripheral nervous system lesions. Its localized distribution in the fingers is unique, and its treatment is unclear. CASE DESCRIPTION: A 56-year-old male presented to the emergency department with a saw-cut index finger injury with associated tendon and nerve injuries. After surgery, he was admitted to physical therapy (PT) with persistent pain, joint stiffness, allodynia, and trophic changes compatible with CRPS-II localized in the index finger. The diagnosis was confirmed after applying the Budapest Criteria, and PT was progressive and individualized according to the patient's needs, including graded motor imagery, mobilizations, exercises, and education. OUTCOMES: After 12 weeks of PT, a clinically significant decrease in pain intensity and improvements in mobility and index finger and upper limb functionality was observed, reducing CRPS symptomatology. DISCUSSION: This report provides information about a unique case of a localized form of CRPS-II. After reviewing the literature on clinical cases of both CRPS-II and localized forms of CRPS, we highlight that the clinical features of this patient and his positive therapeutic response support the importance of translating the scientific evidence on CRPS into clinical practice.

Self-perceived cognitive function and neuropsychological performance in women with fibromyalgia

BACKGROUND: Cognitive dysfunction is a common complain in patients with fibromyalgia (FM). Aim: To assess the perceived cognitive function and cognitive performance in women with FM. MATERIAL AND METHODS: Cross-sectional study including 100 women with FM (FMG) and 100 healthy controls (CG). Self-perceived cognitive functioning was evaluated using the Functional Assessment of Cancer Therapy Cognition scale (FACT-Cogv3). The neuropsychological performance was assessed with the Trail Making Test (TMT-A, TMT-B), Digit Span test (DS), Barcelona test (DS-F/B) and the Frontal Assessment Battery (FAB-E), Spanish version test. Results: The mean scores of all cognitive self-perception factors and all neuropsychological tests were lower in the FMG (p < 0.001). Over 90% of the FMG took longer than the population mean (P50) to complete the TMT-A and TMT-B tests, while in the CG, 1/3 took longer than the P50 in both tests. The minimum expected scores for the DS-F and DS-B tests were not achieved by 40 and 9% of FMG participants, respectively. According to FAB-E, 54% and 24% of FMG were categorized as fronto-subcortical deficit and fronto-subcortical dementia, respectively. CONCLUSIONS: Women with FM have a higher perception of cognitive dysfunction and lower cognitive performance in objective tests than healthy women. More research is needed to explore the clinical, psychosocial, and sociodemographic characteristics that predispose to cognitive deficits in this group of patients.

ANTECEDENTESA: La disfunción cognitiva es una queja común en pacientes con fibromialgia (FM). Objetivo: Investigar la función cognitiva percibida y el desempeño cognitivo en mujeres chilenas con FM. MATERIAL Y MÉTODOS: Estudio transversal incluyendo a 100 mujeres con FM (GFM) y 100 mujeres como controles sanos (GC). El funcionamiento cognitivo autopercibido se evaluó mediante la prueba Functional Assessment of Cancer Therapy Cognition scale (FACT-Cogv3). El rendimiento neuropsicológico se evaluó mediante las pruebas Trail Making Test (TMT-A, TMT-B) y Digit Span test (DS), Barcelona test (DS-F/B) y la prueba Frontal Assessment Battery, versión española (FAB-E). RESULTADOS: Las puntuaciones medias de todos los factores de autopercepción cognitiva y todas las pruebas neuropsicológicas fueron significativamente menores en el GFM. Para TMT-A y TMT-B, más del 90% del GFM tardó más que la media poblacional (P50) para completar las pruebas, mientras que en el GC aproximadamente 1/3 requirió más tiempo que el P50 en ambas pruebas. Un 40 y 9% del GFM no obtuvo la puntuación mínima esperada para las pruebas DS-F y DS-B, respectivamente. Según FAB-E, el 54% y 24% del GFM se clasificó como déficit fronto-subcortical y demencia fronto-subcortical, respectivamente. Conclusiones: Las mujeres con FM tienen una mayor percepción de disfunción cognitiva y menor rendimiento cognitivo en pruebas objetivas que mujeres sanas. Se necesita más investigación para explorar las características clínicas, psicosociales y sociodemográficas que predisponen a los déficits cognitivos en este grupo de pacientes.

Self-perceived cognitive function and neuropsychological performance in women with fibromyalgia.

BACKGROUND: Cognitive dysfunction is a common complain in patients with fibromyalgia (FM). AIM: To assess the perceived cognitive function and cognitive performance in women with FM. MATERIAL AND METHODS: Cross-sectional study including 100 women with FM (FMG) and 100 healthy controls (CG). Self-perceived cognitive functioning was evaluated using the Functional Assessment of Cancer Therapy Cognition scale (FACT-Cogv3). The neuropsychological performance was assessed with the Trail Making Test (TMT-A, TMT-B), Digit Span test (DS), Barcelona test (DS-F/B) and the Frontal Assessment Battery (FAB-E), Spanish version test. RESULTS: The mean scores of all cognitive self-perception factors and all neuropsychological tests were lower in the FMG (p < 0.001). Over 90% of the FMG took longer than the population mean (P50) to complete the TMT-A and TMT-B tests, while in the CG, 1/3 took longer than the P50 in both tests. The minimum expected scores for the DS-F and DS-B tests were not achieved by 40 and 9% of FMG participants, respectively. According to FAB-E, 54% and 24% of FMG were categorized as fronto-subcortical deficit and fronto-subcortical dementia, respectively. CONCLUSIONS: Women with FM have a higher perception of cognitive dysfunction and lower cognitive performance in objective tests than healthy women. More research is needed to explore the clinical, psychosocial, and sociodemographic characteristics that predispose to cognitive deficits in this group of patients.