Mézières Method as a practice of embodiment in patients with low back pain: a mixed study.

INTRODUCTION: The objectives of this study were to determine the effects of the Mézières Method (MM) on pain and disability related to low back pain (LBP), compared to a program of heat, massage and exercise, and to understand the meaning of the bodily experience with the MM. PATIENTS AND METHODS: Mixed methods convergent parallel design, combining an equivalent randomized clinical trial with a qualitative phenomenological approach. Sixty-one participants aged 18-65 years with chronic non-specific LBP lasting more than 3 months. Patients were randomized into two groups: the MM group (n = 29) and the comparison group (CG) who received heat, massage plus flexibility and strengthening exercises (n = 31). MM and CG participants underwent 10 one-hour physical therapy sessions over a 5-week period and were evaluated three times: pre-intervention, post-intervention and follow-up at 6 weeks after the end of treatment. RESULTS: Both groups reported positive effects on LBP . MM group showed superior effects in pain relief in the short term (Cohen's D 0.80; p = 0.004). Participants interpreted the interaction with the MM as a teaching-learning process that allowed body awareness. CONCLUSION: Both treatment were similarly beneficial but MM had superior effects on pain in the short term. MM is perceived by the participants as a teaching-learning process focused on body awareness that facilitate effective management of LBP.

Improving motor skills and psychosocial behaviors in children with autism spectrum disorder through an adapted judo program.

Introduction: This study aimed to investigate the long-term effects of an adapted judo program on the motor skills and psychosocial abilities of children with Autism Spectrum Disorder (ASD). Methods: All participants had been diagnosed with ASD and were assessed twice, one time at the start of the intervention and again 6 months later, with the Test of Gross Motor Development (TGMD-3) and the Gilliam Autism Rating Scale-Third Edition (GARS-3). A one-way repeated measures MANOVA was carried out in order to evaluate these assessments, and a mediation analysis was done to determine the relationship between them. Results: The experimental group significantly improved (p < 0.05) from the pre-test to the post-test for several subtests of the TGMD-3 and the GARS-3. Conclusion: The study shows that participation in an adapted judo program clearly helps to improve the motor skills and psychosocial behaviors of children with ASD.

Cost-effectiveness of a programme to address sedentary behaviour in older adults: results from the SITLESS RCT.

BACKGROUND: This study details the within-trial economic evaluation and long-term economic model of SITLESS, a multi-country, three-armed randomized controlled trial comparing a combined intervention of exercise referral schemes (ERS) enhanced by self-management strategies (SMS) against ERS alone and usual care (UC). METHODS: A cost-utility analysis, conducted from the base-case perspective of the National Health Service and personal and social services, estimated the incremental cost per incremental quality-adjusted life year (QALY) and years in full capability (YFC). A secondary analysis combined the costs with a broad set of outcomes within a cost-consequence framework, from a societal perspective. A Markov-type decision-analytic model was developed to project short-term changes in physical activity to long-term outcomes and costs, over a 5- and 15-year time horizon. RESULTS: The results of the within-trial analysis show that SMS+ERS is highly likely to be cost-effective compared to ERS alone (ICER €4270/QALY), but not compared to UC. Participants allocated to the SMS+ERS group also showed an improvement in YFC compared to ERS alone and UC. The long-term analysis revealed that SMS+ERS is likely to be a cost-effective option compared to ERS and UC over a 5-year, but not with a 15-year horizon, being then dominated by ERS alone. CONCLUSION: This research provides new evidence that SMS is a cost-effective add-on to ERS strategies. This economic evaluation informs the case for further, cost-effective, refinement of lifestyle change programmes targeted to older adults, with the aim of ultimately reducing the impact of non-communicable diseases in this population.

Effects and experience with the Mézières method in people with low back pain: A mixed methods study.

BACKGROUND: Low back pain (LBP) is one of the most common reasons for visiting the doctor. The Mézières method (MM) emphasises body awareness and uses a global postural rehabilitation approach. It is used in the management of LBP, but its effectiveness has received limited formal evaluation. OBJECTIVE: To determine the effects of MM on quality of life, pain and functional disability in people with LBP and understand the patient's bodily experience during the MM intervention. METHODS: This protocol study of single-blind randomised controlled trial with a mixed methods design will include 54 people with LBP aged 18 to 65 years. Participants will be randomised into two groups, one will receive MM and the other will receive a control intervention, administered through 10 treatment sessions. Participants will also construct a narrative to provide an understanding of their bodily experience. RESULTS: The assessed outcomes will include pain, back pain-related disability assessed using the Roland Morris Questionnaire, and quality of life related to health assessed using the SF12. Outcomes will be assessed at baseline, after the intervention and at a 6 weeks follow-up.

Exercise referral schemes enhanced by self-management strategies to reduce sedentary behaviour and increase physical activity among community-dwelling older adults from four European countries: protocol for the process evaluation of the SITLESS randomised controlled trial.

INTRODUCTION: SITLESS is a randomised controlled trial determining whether exercise referral schemes can be enhanced by self-management strategies to reduce sedentary behaviour and increase physical activity in the long term, in community-dwelling older citizens. The intervention is complex and requires a process evaluation to understand how implementation, causal mechanisms and context shape outcomes. The specific aims are to assess fidelity and reach of the implementation, understand the contextual aspects of each intervention site, evaluate the mechanisms of impact, and explore perceived effects. METHODS AND ANALYSIS: Following the Medical Research Council guidance on complex interventions, a combination of qualitative and quantitative procedures is applied, including observational checklists and attendance registries, standardised scales (ie, Marcus's Self-Efficacy Questionnaire, Physical Activity Self-Regulation Scale and the Lubben Social Network Scale) at baseline, postintervention and follow-up assessments, semistructured questionnaires gathering contextual characteristics, and participant observations of the sessions. Semistructured interviews and focus groups with the participants and trainers are conducted at postintervention and during the follow-up to explore their experiences. Outcomes from the standardised scales are analysed as moderators within the impact evaluation. Descriptive results on context and perceived effects complement results on impact. The qualitative and quantitative findings will help to refine the logic model to finally support the interpretation of the results on the effectiveness of the intervention. ETHICS AND DISSEMINATION: The study design was approved by the respective Ethical Committee of Ramon Llull University, Southern Denmark, Northern Ireland and Ulm University. Participation is voluntary, and all participants are asked to sign informed consent before starting the study. A dissemination plan operationalises how to achieve a social impact by reaching academic and non-academic stakeholders. A data management plan describes the specific data sets and regulates its deposition and curation. All publications will be open access. TRIAL REGISTRATION NUMBER: NCT02629666; Pre-results.

Cost-effectiveness of exercise referral schemes enhanced by self-management strategies to battle sedentary behaviour in older adults: protocol for an economic evaluation alongside the SITLESS three-armed pragmatic randomised controlled trial.

INTRODUCTION: Promoting physical activity (PA) and reducing sedentary behaviour (SB) may exert beneficial effects on the older adult population, improving behavioural, functional, health and psychosocial outcomes in addition to reducing health, social care and personal costs. This paper describes the planned economic evaluation of SITLESS, a multicountry three-armed pragmatic randomised controlled trial (RCT) which aims to assess the short-term and long-term effectiveness and cost-effectiveness of a complex intervention on SB and PA in community-dwelling older adults, based on exercise referral schemes enhanced by a group intervention providing self-management strategies to encourage lifestyle change. METHODS AND ANALYSIS: A within-trial economic evaluation and long-term model from both a National Health Service/personal social services perspective and a broader societal perspective will be undertaken alongside the SITLESS multinational RCT. Healthcare costs (hospitalisations, accident and emergency visits, appointment with health professionals) and social care costs (eg, community care) will be included in the economic evaluation. For the cost-utility analysis, quality-adjusted life-years will be measured using the EQ-5D-5L and capability well-being measured using the ICEpop CAPability measure for Older people (ICECAP-O) questionnaire. Other effectiveness outcomes (health related, behavioural, functional) will be incorporated into a cost-effectiveness analysis and cost-consequence analysis.The multinational nature of this RCT implies a hierarchical structure of the data and unobserved heterogeneity between clusters that needs to be adequately modelled with appropriate statistical and econometric techniques. In addition, a long-term population health economic model will be developed and will synthesise and extrapolate within-trial data with additional data extracted from the literature linking PA and SB outcomes with longer term health states.Methods guidance for population health economic evaluation will be adopted including the use of a long-time horizon, 1.5% discount rate for costs and benefits, cost consequence analysis framework and a multisector perspective. ETHICS AND DISSEMINATION: The study design was approved by the ethics and research committee of each intervention site: the Ethics and Research Committee of Ramon Llull University (reference number: 1314001P) (Fundació Blanquerna, Spain), the Regional Committees on Health Research Ethics for Southern Denmark (reference number: S-20150186) (University of Southern Denmark, Denmark), Office for Research Ethics Committees in Northern Ireland (ORECNI reference number: 16/NI/0185) (Queen's University of Belfast) and the Ethical Review Board of Ulm University (reference number: 354/15) (Ulm, Germany). Participation is voluntary and all participants will be asked to sign informed consent before the start of the study.This project has received funding from the European Union's Horizon 2020 research and innovation programme under grant agreement number 634 270. This article reflects only the authors' view and the Commission is not responsible for any use that may be made of the information it contains.The findings of the study will be disseminated to different target groups (academia, policymakers, end users) through different means following the national ethical guidelines and the dissemination regulation of the Horizon 2020 funding agency.Use of the EuroQol was registered with the EuroQol Group in 2016.Use of the ICECAP-O was registered with the University of Birmingham in March 2017. TRIAL REGISTRATION NUMBER: NCT02629666; Pre-results.

Comparison of Static Balance on a Platform in Young Adults With Down Syndrome Before and After a Dance Program.

The purpose of the study was to compare postural control in static standing in young adults with and without Down syndrome (DS), with eyes closed and eyes open, before and after an 18-wk dance-based training program. The study included 11 young people with DS age 20.5 (1.3) yr and 11 without DS age 20.2 (2.0) yr. All parameters were recorded before and after the training program. Parameters related to center of pressure (COP; closed and open eyes) were recorded from a platform with the participant in bipedal standing position during 30 s. The results suggest that young people with DS have worse COP control in both visual conditions (closed and open eyes) and are affected by visual information in a different way than their peers without DS. In the group of young adults with DS, the dance-based training program improved some parameters related to the use of visual input in controlling COP.

El proceso de envejecimiento de las personas con síndrome de Down: estudio multicéntrico para la detección de los cambios neuropsicológicos / No disponible

La mejora en la calidad de vida ha favorecido considerablemente el aumento de la esperanza de vida de las personas con síndrome de Down (SD), motivo por el cual es preciso describir las características neuropsicológicas que presenta su proceso de envejecimiento, con la finalidad de realizar una adecuada prevención y una intervención ajustada a las necesidades de cada persona. En esta investigación se ha realizado un estudio multicéntrico en el que han participado un total de 217 personas adultas con SD, administrando un screening cognitivo que permite obtener una valoración general y básica del estado cognitivo de los participantes. Los resultados nos indican que las personas adultas con SD de edades comprendidas entre los 38 y los 62 años presentan cambios neuropsicológicos significativos en las áreas de lenguaje, memoria y estado cognitivo general, en relación a las personas adultas con SD más jóvenes. En conclusión, el seguimiento en el proceso de envejecimiento favorece la detección temprana y la prevención del deterioro cognitivo, promoviendo así un envejecimiento activo y saludable

The improvement in the quality of life has significantly contributed to increase the life expectancy of people with Down syndrome (DS). It is necessary, then, to describe the neuropsychological characteristics during their aging process, in order to make a proper prevention and intervention adjusted to the needs of each person. This research has conducted a multicenter study with a total of 217 adults with DS participants. It was applied a cognitive screening which allows a general and basic assessment of cognitive status of participants. The results indicate that adults with DS between 38 and 62 years have significant neuropsychological changes in the areas of language, memory and general cognitive status compared to younger adults with DS. In conclusion, monitoring the aging process facilitates an early detection and prevention of cognitive decline, thus promoting active and healthy aging

Effects of aerobic, resistance and balance training in adults with intellectual disabilities.

Adults with intellectual disability (ID) have decreased cardiovascular fitness and strength present with lower rates of physical activity (PA), and often have balance and functional impairments. The purpose of this study was to investigate the effect of a combined PA program (CPAP) utilizing aerobic, strength and balance training on cardiovascular fitness, strength, balance and functional measures in a controlled clinical trial. Adults with mild to moderate ID were assigned into either the intervention group (IG; n=37) or the control group (CG; n=29). The IG trained 3 day/week, 1 h/day over 14 weeks, while the CG did not participate in any exercise program. Cardiovascular fitness, strength, balance, flexibility and functional ability were assessed pre-post training. The IG increased cardiovascular fitness (26.8 vs. 29.3 ml kg(-1) min(-1)), handgrip strength (19.2 vs. 21.9 kg), leg strength, and balance following the training period (p<.05). Body weight (70.1 vs. 68.1 kg) and body mass index (27.4 vs. 26.6 kg m(-2)) decreased (p<.05) in the IG group. The CG showed no changes in any parameter. These data suggest a combined aerobic, strength and balance exercise training program is beneficial among individuals with ID.