Treatment of infant colic with craniosacral therapy. A randomized controlled trial.

OBJECTIVE: To evaluate the number of craniosacral therapy sessions that can be helpful to obtain a resolution of the symptoms of infantile colic and to observe if there are any differences in the evolution obtained by the groups that received a different number of Craniosacral Therapy sessions at 24 days of treatment, compared with the control group which did not received any treatment. METHODS: Fifty-eight infants with colic were randomized into two groups of which 29 babies in the control group received no treatment and those in the experimental group received 1-3 sessions of craniosacral therapy (CST) until symptoms were resolved. Evaluations were performed until day 24 of the study. In this study crying hours served as primary outcome. The secondary outcome were the hours of sleep and the severity, measured by an Infantile Colic Severity Questionnaire (ICSQ). RESULTS: Significant statistical differences were observed in favor of experimental group compared to the control group on day 24 in crying hours (mean difference = 2.94, at 95 %CI = 2.30-3.58; p < 0.001) primary outcome, and also in hours of sleep (mean difference = 2.80; at 95 %CI = - 3.85 to - 1.73; p < 0.001) and colic severity (mean difference = 17.24; at 95 %CI = 14.42-20.05; p < 0.001) secondary outcomes. Also, the differences between the groups ≤ 2 CST sessions (n = 19), 3 CST sessions (n = 10) and control (n = 25) were statistically significant on day 24 of the treatment for crying, sleep and colic severity outcomes (p < 0.001). CONCLUSION: Babies with infantile colic may obtain a complete resolution of symptoms on day 24 by receiving 2 or 3 CST sessions compared to the control group, which did not receive any treatment.

[Healthcare for premenstrual discomfort patients. Women's perspective]. / Atención sanitaria al malestar premenstrual. La perspectiva de las mujeres.

OBJECTIVE: The prevalence of premenstrual discomfort among Spanish women is very high, and has a negative impact on their quality of life. By adopting the biopsychosocial approach, this study aims to understand women's experiences and insights, delve further into their beliefs and attitudes towards premenstrual syndrome and menstrual suppression, and to identify their proposals in order to adapt healthcare professionals' response to their needs and demands. METHODS: A qualitative study was conducted based on individual in-depth interviews with 16 women located in the Granada region. Purposive sampling was made using theoretical profiles. Informed consent was given. The study included data assessment, investigator triangulation, and a literature review. RESULTS: Premenstrual discomfort has an impact on physical and psychological health, disrupting daily lives and resulting in self-medication. Healthcare is considered deficient, since remedies are limited to medicalisation, but the source of the discomfort is not investigated. Different beliefs about the premenstrual syndrome (PMS) were found: PMS is inherent to menstrual cycle and cannot be avoided; PMS is the result of endogenous factors (such as genetics, defects or biochemical and hormonal disorders); exogenous factors (such as stress, eating habits, or exercise); the science and industry describe and treat PMS as a disease. Menstrual suppression is considered an option by women with children, though there is reticence due to the side effects found. Health education programmes for women are proposed, as well as the appropriate training for health professionals in order to overcome the pharmacological approach. CONCLUSIONS: The biopsychosocial approach helps to determine the perspective of the women, their needs and expectations in order to provide better healthcare services to premenstrual discomfort patients.

Estudio descriptivo sobre la Clasificación Internacional del Funcionamiento y el diagnóstico de fisioterapia / Descriptive study on the International Classification of Functioning and diagnosis of physiotherapy

ANTECEDENTES/OBJETIVO: El diagnóstico de fisioterapia es uno de los eslabones menos desarrollados en la profesión y, aunque se reconoce a la Clasificación Internacional del Funcionamiento (CIF) como marco teórico, no se interpretan adecuadamente las propuestas y etiquetas diagnósticas. El objetivo de este estudio es describir los elementos clave que configuran el diagnóstico en fisioterapia integrando el contexto de la CIF. MÉTODO: Estudio descriptivo, observacional, transversal de corte cualitativo, basado en el modelo de análisis interpretativo de Grounded Theory. En primer lugar, se lleva a cabo una encuesta tipo Likert (n = 42) y, en segundo lugar, se realiza un análisis interpretativo de un grupo de discusión. RESULTADOS: El diagnóstico de fisioterapia es percibido por los participantes del grupo de discusión como un sello de identidad de la profesión, por su objetividad, su carácter científico y por favorecer la comunicación interdisciplinar. Se identificaron trece códigos organizados en cuatro categorías. Estas categorías son: las áreas de desarrollo del diagnóstico de fisioterapia, los perfiles de los fisioterapeutas, los conocimientos sobre la Clasificación, y las competencias de la Clasificación. Los códigos que definen estas categorías son, respectivamente: los roles académico, profesional e investigador; los perfiles clínico-asistencial, científico y afectivo-emocional; las definiciones, desventajas, mejoras y utilidad en el diagnóstico de fisioterapia; y los componentes de salud, conjuntos básicos y nivel internacional. CONCLUSIÓN: Los códigos obtenidos definen el diagnóstico de fisioterapia en el contexto actual de la CIF. Estos son aspectos para el estudio y elementos de referencia para desarrollar etiquetas diagnósticas acordes con las necesidades de la fisioterapia actual

BACKGROUND/OBJECTIVE: Physiotherapy assessment is one of the least developed elements of the profession. Diagnostic proposals and labels are not properly interpreted, although the International Classification of Functioning (ICF) is recognized as a theoretical framework. The objective of the study is to describe the key elements that make up the physiotherapy assessment within the context of the ICF. METHOD: A descriptive, observational, cross-sectional qualitative study based on the Grounded Theory interpretative analysis model. First, a Likert-type survey (n = 42) is carried out, and second, an interpretative analysis of a discussion group. RESULTS: Physiotherapy assessment is perceived by the discussion group respondents as a hallmark of the profession, due to its objectivity, its scientific nature and in promoting interdisciplinary communication. Thirteen codes organized into four categories were identified. These categories are areas of development of physiotherapy diagnosis, physiotherapist profiles, knowledge about the ICF, and domains of the classification. The codes that define these categories are: academic, professional and research roles; clinical, scientific and affective-emotional profiles; definitions, disadvantages, improvements and diagnostic suitability; and health-related domains, basic sets and international level. CONCLUSION: The codes obtained define the physiotherapy assessment in the current context of the ICF. These elements are essential for study and to develop diagnostic labels according to the needs of current physiotherapy

Effectiveness of craniosacral therapy in the treatment of infantile colic. A randomized controlled trial.

OBJECTIVES: To determine the effectiveness of Craniosacral Therapy (CST) for the treatment of infantile colic. MATERIAL AND METHODS: This randomized controlled trial was conducted on 58 infants, aged 0-84 days, diagnosed with infantile colic. The babies received a 30-40 minute CST session once a week (experimental group) or no treatment (control group). Babies in the CST group received either 1, 2 or 3 CST sessions over a 14-day period. Data were collected at 4 different times over the 24-day period, day 0 (baseline), day 7, day 14 and day 24. Crying (primary outcome) and sleep (secondary outcome) were evaluated using a crying and sleep diary, and colic severity was measured using the Infant Colic Severity Questionnaire (secondary outcome). RESULTS: There was a statistically significant difference between groups (CST and control) in crying hours (F = 188.47; p < 0.0005; η2 = 0.78), sleep hours (F = 61.20; p < 0.0005, η2 = 0.54) and colic severity (F = 143.74; p < 0.0005, η2 = 0.73) across all the time points. In comparison with the control group, CST babies reported significant and clinically relevant effects in crying hours on day 7 (-2.47 h (95%CI, -2.95 to -1.99); p < 0.0005; d = 1.73), on day 14 (-3.29 h (95%CI, -3.7 to -2.8); p < 0.0005; d = 2.87) and on day 24 (-3.20 h (95%CI, -3.7 to -2.6); p < 0.0005; d = 2.54); in sleep hours on day 7 (-2.47 h (95%CI, -2.95 to -1.99); p < 0.0005; d = 1.73) on day 14 (-3.29 h (95%CI, -3.7 to -2.8); p < 0.0005; d = 2.87) and on day 24 (-3.20 h (95%CI, -3.7 to -2.6); p < 0.0005; d = 2.54). CONCLUSIONS: Craniosacral therapy appears to be effective and safe for infantile colic by reducing the number of crying hours, the colic severity and increasing the total hours of sleep.

La adherencia al entrenamiento muscular del suelo pélvico en las mujeres con incontinencia urinaria. Revisión sistemática de la literatura / Adherence to pelvic floor muscle training in women with urinary incontinence. Systematic review of the literature

Antecedentes: La incontinencia urinaria femenina es un problema de salud de elevada prevalencia, costes sociales y económicos. El entrenamiento muscular del suelo pélvico es el tratamiento conservador más utilizado en mujeres con cualquier tipo de incontinencia urinaria, pero requiere de la adhesión a dichos programas de entrenamiento. Sin embargo, los estudios publicados hasta la fecha alertan de la falta de adherencia a estos programas, identificándose como una barrera para el proceso de recuperación. Objetivo: El objetivo de este trabajo es describir la adherencia al entrenamiento muscular del suelo pélvico en las mujeres con incontinencia urinaria. Estrategia de búsqueda y selección de estudios: Se realizó una revisión bibliográfica en las bases de datos PubMed, Medes, LILACS, CINAHL, CUIDENPlus, PsycINFO, ENFISPO, La biblioteca Cochrane Plus, Trip, ProQuest, PROSPERO, Epistemonikos, The Cochrane Library, SPORTDiscus, PEDro, IBECS, Web of Science y Scopus, completándose con una estrategia de búsqueda manual. Los artículos incluidos fueron ensayos controlados aleatorizados o análisis secundarios de los mismos, publicados entre 2007 y 2018. La evaluación de la calidad metodológica se realizó con la escala PEDro, realizándose la implementación de las normas PRISMA. Resultados: Siete artículos se incluyeron en esta revisión. Las tasas de adherencia variaron entre el 92 y el 53,55% en el corto plazo y entre el 80 y el 38,1% en el seguimiento. Los sistemas de medición se basaron en diarios, cuestionarios y datos recogidos por los fisioterapeutas. La falta de homogeneidad en los estudios supone una limitación para un metaanálisis válido. Conclusiones: Las tasas de adherencia del entrenamiento muscular del suelo pélvico en incontinencia urinaria femenina son bajas, siendo necesarias acciones que puedan homogeneizar los sistemas de medición y las estrategias de mejora de la adherencia terapéutica

Introduction: Female urinary incontinence is a health problem of high prevalence, social and economic costs. Training of the pelvic floor muscles is the most used conservative treatment in women with any type of urinary incontinence, but requires adherence to these programs. However, studies published to date warn of the lack of adherence to these programs, identifying this as a barrier to the recovery process. Objective: The objective of this work is to describe the adherence to pelvic floor muscle training in women with urinary incontinence. Search strategy and study selection: A bibliographic review was made in the databases PubMed, Medes, LILACS, CINAHL, CUIDENPlus, PsycINFO, ENFISPO, The Cochrane Plus library, Trip, ProQuest, PROSPERO, Epistemonikos, The Cochrane Library, SPORTDiscus, PEDro, IBECS, Web of Science and Scopus, completing with a manual search strategy. The articles included were randomised controlled trials, or secondary analyses of these, published between 2007 and 2018. The evaluation of the methodological quality was carried out using the PEDro scale, with the implementation of the PRISMA standards. Results: Seven articles were included in this review. Adherence rates varied between 92% and 53.55% in the short term, and between 80% and 38.1% in the follow-up. The measurement systems were based on diaries, questionnaires, and data collected by the physiotherapists. The lack of homogeneity in the studies is a limitation for a valid meta-analysis. Conclusions: The adherence rates of pelvic floor muscle training in female patients with urinary incontinence are low, and actions are needed to standardise measurement systems, as well as strategies to improve therapeutic adherence

Corrigendum to "Effectiveness of Massage Therapy and Abdominal Hypopressive Gymnastics in Nonspecific Chronic Low Back Pain: A Randomized Controlled Pilot Study".

[This corrects the article DOI: 10.1155/2018/3684194.].

Effectiveness of Massage Therapy and Abdominal Hypopressive Gymnastics in Nonspecific Chronic Low Back Pain: A Randomized Controlled Pilot Study.

BACKGROUND: There are a great number of interventions in physiotherapy, but with little evidence of their effectiveness in chronic low back pain. Therefore, this study assesses effectiveness of Massage Therapy and Abdominal Hypopressive Gymnastics and the combination of both to decrease pain and lumbar disability while increasing joint mobility and quality of life in patients with chronic nonspecific low back pain. METHODS: A randomized, single-blinded, controlled, clinical trial with sample (n = 27) was comprised of patients between 20 and 65 years, diagnosed with pain of mechanical origin characterized by having a duration of at least 12 weeks and no serious complications. Each group received 8 interventions of 30 minutes. RESULTS: Friedman ANOVA test obtained statistically significant differences of Oswestry, NRS, and Schober variables (p < 0.05) in the three measurements (pretest, posttest 1, and posttest 2), in each individual group. ANOVA Kruskal-Wallis test was used for comparison between groups, and Oswestry Disability values were significantly higher (p = 0.024) in the group receiving both treatments. CONCLUSION: Both individual groups reduce pain levels, improve disability, and increase the flexibility of the lumbar spine. The combination therapy provides greater benefits in terms of lumbar disability. This study is registered on March 8, 2016, with NCT02721914.

Calidad de vida profesional de los fisioterapeutas en el ámbito hospitalario público de Sevilla / Professional quality of life in physiotherapists in public hospitals of Seville, Spain

Objetivo: Conocer el nivel de calidad de vida profesional percibida por los fisioterapeutas del ámbito hospitalario público del área metropolitana de Sevilla y analizar su relación con variables sociodemográficas y laborales. Material y métodos: Estudio multicéntrico descriptivo transversal, desarrollado en el área metropolitana de Sevilla: Hospital Universitario Virgen del Rocío, Virgen Macarena y Virgen de Valme. Los participantes fueron todos los fisioterapeutas de los hospitales anteriormente citados. La tasa de respuesta fue del 96 por mil (n=48). Instrumentos de medida: encuesta anónima que incluye el cuestionario de calidad de vida profesional CVP-35, además de variables sociodemográficas y laborales. Resultados: El perfil del fisioterapeuta es una mujer (72,9 por mil ), de 44 años (Q1 41,75; Q3 57), casada (79,2 por mil ), con 2 hijos (Q1 1; Q3 2), con un tiempo de experiencia profesional de 22 años (Q1 16,25; Q3 30), con una antigüedad en el puesto de 6,5 años (Q1 4; Q3 16,83), plaza en propiedad (64,6 por mil ), jornada completa (89,6 por mil ) y turno de mañana (95,8 por mil ). La valoración global sobre la calidad de vida profesional percibida es de 7 puntos (Q1 5; Q3 8). En relación con las 3 dimensiones valoradas, la media más alta se encuentra en la «motivación intrínseca», con 8,17 (DT 1), «cargas de trabajo», con 6,06 (DT 1,2), y «apoyo directivo», con 5,38 (DT 1,54). No existen diferencias estadísticamente significativas con las variables sociolaborales. Conclusiones: Los fisioterapeutas de los hospitales de la ciudad de Sevilla tienen una calidad de vida en el trabajo media-alta. Presentan una adecuada motivación para realizar su trabajo, pero muestran cierta insatisfacción relacionada con el apoyo directivo y la carga de trabajo

Objective: Evaluate the level of professional quality of life perceived by the public hospital physiotherapists of the metropolitan area of Seville, and analyse its relationship with sociodemographic and occupational variables. Methods: Multicentre descriptive cross-sectional observational study developed in metropolitan area of Seville, including the University Hospital Virgen del Rocío, Virgen Macarena and Virgen de Valme. The participants were all physiotherapists from the aforementioned hospitals. The response rate was 96 per-mille (n=48). The measurement tool used was a questionnaire on professional quality of life (CVP-35), as well as the collecting of sociodemographic and occupational variables. Results: The profile of the physiotherapist is female (72.9 per-mille ), 44 years-old (Q1 41.75; Q3 57), married (79.2 per-mille ), with 2 children (Q1 1; Q3 2), with a long experience as a physiotherapist of 22 years (Q1 16.25; Q3 30), with a job tenure of 6.5 years (Q1 4; Q3 16.83), tenured (64.6 per-mille ), full time (89.6 per-mille ), and morning shift (95.8 per-mille ). The overall assessment of the perceived professional quality of life scored 7 points (Q1 5; Q3 8). In relation to the 3 dimensions evaluated, the highest score obtained was in the "intrinsic motivation" with 8.17 (SD 1), "workloads", with 6.06 (SD 1.2), and "management support" with 5.38 (SD 1.54). There were no statistically significant differences as regards social and occupational variables. Conclusions: Physiotherapists in hospitals of the city of Seville have a medium-high professional quality of life. They have adequate motivation to do their job, but show some dissatisfaction as regards management support and workload

Tools assessment and diagnosis to infant colic: a systematic review.

BACKGROUND: Infant colic occurs between 10% and 40% of healthy born children in their first year of life. Its assessment is complex, and there are only a few instruments of appraisement and diagnosis. METHODS: Scientific articles located through a systematic review using the Pubmed, Scopus, Cochrane, PEDro, Dialnet, IME and Dialnet databases. Two researchers obtained data independently from relevant studies previously identified. Risk of bias was assessed according to the methods recommended by the Cochrane Collaboration, with reporting following the preferred reported items for systematic reviews and meta-analyses guidelines and evaluating their methodological quality based on the EMPRO scale. RESULTS: Four tools were obtained for valuation of infant colic. Parental diary of infant cry and fuss behaviour, Crying Pattern Questionnaire, Infant Colic Scale and, lastly, a validity of the Turkish version of the Infant Colic Scale. CONCLUSIONS: Analysis of the existing tools involves the need to design and validate new assessment scales for this clinical frame.

Evolución de la estructura y la objetividad científica de los artículos publicados en la revista Fisioterapia (1979-2008) / Evolution of the structure and scientific objectivity of the articles published on the journal of Fisioterapia (1979-2008)

Introducción: La forma de adecuar conceptualmente el cuerpo de conocimientos de la fisioterapia debe fundamentarse en la aplicación del método científico. Por tanto, la evaluación de la actividad científica de los artículos publicados proporciona uno de los mejores indicadores acerca del cómo se está construyendo el conocimiento en la profesión. Objetivos: Analizar los primeros 30 años de publicación de la revista Fisioterapia, para conocer cómo han evolucionado los artículos originales publicados en relación con su estructura organizativa, su objetividad en la exposición de contenidos y el uso de recursos de estadísticos. Material y método: Estudio observacional descriptivo. La muestra de estudio: 781 artículos publicados entre 1979 y 2008. Las variables estudiadas en cada artículo se organizaron en sobre la base de 3 dimensiones de análisis: a) estructura científica de los artículos publicados; b) análisis de la objetividad/subjetividad de los artículos, y c) instrumentos estadísticos. Resultados: La organización y la estructura científica de los artículos publicados mejoran en cada uno de los periodos históricos analizados. Los últimos 15 años (1994-2008) muestran una tendencia creciente al uso de análisis descriptivos y estadística inferencial. Los valores de subjetividad en el contenido de los artículos desde el inicio de la publicación 74% (1979-1983) han disminuido progresivamente hasta valores del 2,2% para el último periodo (2004-2008). Conclusiones: La estructura científica y la objetividad de los artículos publicados han experimentado una mejora progresiva, que sobre todo se ha acentuado durante el último periodo de estudio (2004-2008)

Introduction: Conceptual adaptation of the body of knowledge of physiotherapy should be based on the application of the scientific method. Thus, evaluating the scientific activity of published articles provides one of the best indicators on how knowledge is being constructed in the profession. Objectives: This paper has aimed to analyze the first thirty years of publication of the journal of «Fisioterapia» (Physiotherapy), in order to know how the published original articles have evolved in relation to their organizational structure, their objectivity in the presentation of contents and their use of statistical resources. Material and method: A descriptive observational study was performed. The study sample included 781 articles published between 1979 and 2008. The variables studied in each article were organized into three dimensions of analysis: a) scientific structure of articles published, b) analysis of the objectivity / subjectivity of the articles, and c) Statistical tools. Results: The organization and scientific structure of the articles published have improved in each one of the historical periods being studied. The last fifteen years (1994-2008) have shown a clear and growing trend towards the use of numerical and descriptive analysis as well as the incorporation of inferential statistics tests. The content subjectivity values of the articles from when publication began -74% (1979-1983)- have been progressively decreasing until reaching 2.2% for the last period studied (2004-2008). Conclusions: The scientific structure and objectivity of the articles published have shown a growing improvement, this being especially pronounced during the last study period (2004-2008)

Afectación de la calidad de vida en mujeres con incontinencia urinaria / Impact on quality of life in women with urinary incontinence

Objetivo Valorar la repercusión que la incontinencia urinaria tiene en la calidad de vida de las mujeres atendidas en el Centro Urológico San Ignacio (Sevilla).Material y métodos Estudio descriptivo sobre 34 mujeres que acudieron a consulta entre 2008 y 2009, diagnosticadas de incontinencia urinaria en cualquiera de sus principales formas clínicas de presentación: incontinencia urinaria de esfuerzo, de urgencia y mixta. La recogida de datos se realizó mediante 2 cuestionarios: uno para valorar aspectos de severidad clínica de la incontinencia, y otro, el Kings Health Questionnaire, para valorar la calidad de vida. Resultados La edad media de las pacientes fue 52,97 con una desviación típica de 11,41 años y con 7,55 años de evolución de incontinencia, el 60% padecían incontinencia de esfuerzo. Las dimensiones: salud general, gravedad e impacto de la incontinencia son las más afectadas. La correlación entre la calidad de vida y los parámetros de severidad de los síntomas es baja, siendo el número de absorbentes usados al día, el que mejor correlaciona con 5 de las 9 dimensiones, destacando la dimensión limitaciones de la AVD (r=0,632 para p=0,000).Conclusiones Las dimensiones más afectadas son las relacionadas con la percepción de salud general, con el impacto que este problema provoca en sus vidas y con la esfera física de las mujeres. En cuanto a la relación entre calidad de vida y severidad clínica encontramos relaciones débiles y sobre todo con el número de absorbentes utilizados al día (AU)

Objective The aim of this study is to evaluate the impact of urinary incontinence on quality of life in women treated in the Urological Center San Ignacio, in Seville. Material and methods A descriptive study was made on 34 women who had come to consultation between 2008 and 2009, and who had been diagnosed of stress, urge or mixed urinary incontinence. Data collection was made using two questionnaires: one based on the King's Health Questionnaire to assess quality of life and the other to evaluate clinical severity aspects of urinary incontinence. Results Our patients’ average age was 52.97 years old, with a standard deviation of 11.41, their incontinence had an evolution of 7.55 years, and 60% of them suffered from stress urinary incontinence. The most affected dimensions were General Health, Severity Measurements and Urinary Incontinence Impact. Correlation between Quality of Life and Symptoms Severity was low, although Number of Absorbents used per day showed a higher correlation with 5 of the 9 dimensions, highlighting the dimension daily life activities limitations (r=0.632 para p< 0.001).Conclusions The most affected dimensions were those related to women's health perception, impact on daily life and physical aspects. We found low correlation between quality of life and clinical severity, especially with the number of absorbents used per day (AU)

Intra- and inter-observer reliability of the application of the cellulite severity scale to a Spanish female population.

BACKGROUND: 'Hexsel, dal'Forno and Hexsel Cellulite Severity Scale' (CSS) was developed to evaluate cellulite with an objective and easy to apply tool. Objective Study CSS intra- and inter-observer reliability in a Spanish female population by evaluating patients' cellulite through photographs of their overall gluteofemoral zone as opposed to its creators who distinguished between buttocks and thigh. METHODS: Cellulite Severity Scale was applied to 27 women, evaluating gluteofemoral cellulite, differentiating between left and right. Evaluations were made by three expert examiners each at three times with a 1-week separation. Variables were the five CSS dimensions (number of evident depressions; depth of depressions; morphological appearance of skin surface alterations; grade of laxity, flaccidity, or sagging skin; and the Nürnberger and Müller classification scale), and the overall CSS score. Cronbach's alpha, intra-class correlation and item total correlation were analysed. RESULTS: Cronbach's alpha values were 0.951 (right) and 0.944 (left). In the intra-observer reliability analysis, intra-class correlation coefficient ranged from 0.993 to 0.999 (P < 0.001) and in the inter-observer analysis were 0.937 (right) and 0.947 (left) (P < 0.001). Item total correlation showed all dimensions to be needed except grade of laxity, flaccidity or sagging skin (0.959 right; 0.955 left). CONCLUSION: Cellulite Severity Scale has excellent reliability and internal consistency when used to evaluate cellulite on the buttocks and back of the thighs considered together. Nevertheless, the dimension grade of laxity, flaccidity or sagging skin does not contribute positively to the final consistency of the scale. This dimension needs to be analysed in greater depth in future studies.

Dismenorrea primaria y fisioterapia / Primary dysmenorrhea and physical therapy

La dismenorrea primaria es una de las alteraciones ginecológicas más frecuentes y probablemente la principal causa de ausentismo laboral y escolar en la mujer, dado el carácter mensual e invalidante que puede alcanzar. Los objetivos marcados al realizar este estudio son profundizar en la etiología, fisiopatología y sintomatología del trastorno, así como en el tratamiento que actualmente se ofrece; determinar la necesidad del abordaje fisioterapéutico y presentar un posible protocolo de intervención. En cuanto al material y método seguido, el presente trabajo se enmarca dentro del paradigma interpretativo. Las características del estudio son descriptivo, observacional, transversal y retrospectivo. Nos basamos en la realización de una revisión bibliográfica (1990-actualidad), así como en la propia experiencia profesional con mujeres que padecen menstruaciones dolorosas. A partir de aquí, entre los resultados destacamos que actualmente el tratamiento de la dismenorrea primaria está fundamentalmente dirigido a inhibir, mediante tratamiento farmacológico, la síntesis de prostaglandinas endometriales. Sin embargo, existen otros procedimientos terapéuticos como la Fisioterapia que, aunque carecen de estudios amplios para ser considerados normas a aplicar, sí son alternativas para casos seleccionados, mientras continúan las investigaciones. Finalmente, entre las conclusiones destacamos que todavía son muchos los efectos adversos del tratamiento farmacológico, por lo que resulta necesaria la búsqueda de alternativas terapéuticas. Resaltamos también el papel fundamental que puede desempeñar la Fisioterapia, sobre todo, en pacientes que no pueden beneficiarse del tratamiento farmacológico tradicional. E insistimos en la necesidad de seguir investigando para hacer validar el arsenal de medidas fisioterapéuticas aplicables ante la dismenorrea primaria

The primary dysmenorrhea is one of the most common gynaecological alterations. Due to its monthly nature and the temporary disablement that it can cause, it is probably the main reason of women labour and school absenteeism. We have raised the next objectives: studing in depth the etiology, the physiopathology and the symptomathology of the upset as well as the therapeutic solutions; making a decision about the physical therapy intervention needs and showing the possibility of a physical therapy intervention protocol. The material and method which we have used is the next one: this study is inserted in the interpretative paradigm. Characteristics of study are descriptive, observative, transverse and retrospective. We are based on a bibliographic revision (1990-present) also on our professional experience with women who suffer painful menstruations. Results: Nowadays the treatment of the primary dysmenorrhea is aimed to inhibit the synthesis of endometrial prostaglandins through pharmacologic treatment. However recent studies evaluate other therapeutic alternatives, between them we can named the Physical Therapy. These alternatives are not based on many scientific studies but they could be successful for particular cases. Finally, we wish to emphasize the next conclusions. Nowadays there are a lot of adverse affects of pharmacologic treatment, therefore it is very necessary the search of therapeutic alternatives. We stick out the fundamental role that Physical Therapy can play, especially on those women who can not benefit from traditional pharmacologic treatment. And, finally, we insist on the necessity of keep investigating to get validate the Physical Therapy measures we propose