Effectiveness of manual lymphatic drainage in women with fibromyalgia: A pilot study.

BACKGROUND: Currently there is no treatment capable of significantly alleviating all the symptoms of fibromyalgia (FM), even though it is a complex syndrome with a high prevalence in the population. DESIGN: Experimental study using a single-blind, randomised, clinical trial. OBJECTIVE: To analyse the efficacy of manual lymphatic drainage (MLD) as an alternative to traditional treatment of fibromyalgia (FM) in women. METHODS: This was an experimental study using a single-blind, randomised, clinical trial of 20 women between 30 and 55 years old with FM. Patients were divided into an experimental group (n = 10) and a control group (n = 10). During the study, 3 measurements of pain (visual analogue scale and algometry), FM impact (Fibromyalgia Impact Questionnaire), sleep quality (Index Pittsburgh), anxiety and depression (Hospital Anxiety and Depression Scale) were recorded. Treatment of the experimental group consisted of 2 weekly MLD sessions for 6 weeks. RESULTS: The effect of the interaction of MLD showed statistically significant results in Right intercostal space (F2,36 = 3.54; p = 0.04; n2p = 0.16). The sleep quality was significantly better favour of the treatment (F2,36 = 4.16; p = 0.01; n2p = 0.20). CONCLUSIONS: MLD therapy demonstrated effects in the experimental group in contrast to the control group across the intervention period concerning the right intercostal space and sleep-related factors. However, MLD did not result in observable alterations in pain perception.

The Relationship between Vegetarian Diet and Sports Performance: A Systematic Review.

INTRODUCTION: In recent years, the vegetarian diet has increased in popularity among athletes. The aim of this review is to ascertain the differences in variables related to performance, nutritional intake, and health in athletes according to whether they are omnivores or vegetarians. METHODOLOGY: A literature search was carried out in different databases: PubMed, Web of Science, Dialnet, and Cochrane. The keywords used were "vegetarian diet", "vegan diet", "exercise", "sport", and "performance". After applying different inclusion criteria, six studies were included in the review. RESULTS: No significant differences were obtained in variables related to physical performance (adherence exercise, Vo2Máx, muscle power, and sprint test) or health (body composition, psychological well-being, and social relationships), but dietary intake was significantly higher in carbohydrates and lower in proteins in vegetarian athletes (p < 0.05). CONCLUSIONS: It cannot be affirmed that vegetarian subjects have a higher sports performance, for which more research should be carried out.

The Effects of Non-Pharmacological Interventions in Fibromyalgia: A Systematic Review and Metanalysis of Predominants Outcomes.

(1) Fibromyalgia (FM) is a chronic musculoskeletal condition with multiple symptoms primarily affecting women. An imbalance in cytokine levels has been observed, suggesting a chronic low-grade inflammation. The main aim of the meta-analysis was to examine the effect of multimodal rehabilitation on cytokine levels and other predominant variables in patients with FM. Furthermore, to examine which non-pharmacological tools have been used to investigate the effects that these can have on cytokines in FM patients. (2) Methods: Searches were conducted in PubMed, Scopus, Web of Science, Cochrane, and ScienceDirect databases. This systematic review and metanalysis followed the PRISMA statement protocol. The methodological quality of the studies was assessed using the PEDro scale, the risk of bias followed the Cochrane Manual 5.0.1, and the GRADE system was used for rating the certainty of evidence. (3) Results: Of 318 studies found, eight were finally selected, with a sample size of 320 women with a mean age of 57 ± 20. The proinflammatory cytokines IL-1ß, IL-6, IL-8 and TNF-α were the most studied. Resistance exercise, aquatic exercise, dynamic contractions, cycling, treadmill, and infrared therapy were the main non-pharmacological tools used. (4) Conclusions: The systematic review with meta-analysis found evidence of elevated cytokine levels in patients with FM, suggesting low chronic inflammation and a possible contribution to central sensitization and chronic pain. However, the effects of physiotherapeutic interventions on cytokine levels are variable, highlighting the importance of considering different factors and the need for further research.

The Lived Experiences of Female Immigrant Carers in Madrid, Spain: A Phenomenological Study.

BACKGROUND: Immigration and population ageing represent circumstances with important sociocultural and economic repercussions. METHODS: A qualitative study using interpretative phenomenological analysis was conducted to understand the daily lives and the work of immigrant women dedicated to caring for older citizens. In-depth interviews and discussion groups were carried out in a group of 40 immigrant carers. Data were analysed via the constant comparative method. RESULTS: Three qualitative themes emerged from the data: 'difficult lives', 'working in the home', and 'the vision of the other'. This study highlights the many difficulties encountered by this population. A sense of vulnerability was described while fulfilling their professional duties due to their migrant condition, experiences of gender inequality, and work status. An emotional connection is necessary to provide care, which is impossible in cases of discrimination. DISCUSSION: Administrative regularisation is necessary to improve the quality of immigrant carers' working conditions.

The Prevalence of Shoulder Disorders among Professional Bullfighters: A Cross-Sectional Ultrasonography Study.

We aimed to investigate clinical and ultrasound signs of shoulder overuse injuries in professional bullfighters; side-to-side differences (dominant vs. non-dominant); and to determine potential differences according to bullfighters' categories. An observational cross-sectional study was conducted. Thirty professional and active bullfighters were assessed. A bilateral ultrasound assessment of the subacromial bursa, long biceps head tendon (LHBT), and rotator cuff was performed to determine the presence of bursitis, subluxation, partial or total tendon rupture, tenosynovitis, or calcification. Supraspinatus tendon thickness was measured. Finally, a battery of clinical orthopedic tests (Yergason, Jobe, infraspinatus, Gerber, and bursa tests) were also performed. Most identified ultrasound findings were located in the dominant side, being the presence of bursitis (n = 9; 30%), LHBT tenosynovitis (n = 8; 26.7%), and subscapularis tendon calcification (n = 5; 16.7%) the most prevalent. No side-to-side or between-categories differences were found for supraspinatus tendon thickness (all, p > 0.05). The most frequent positive signs were the infraspinatus test (40.0%), Gerber lift-off test (33.3%), and bursitis, Jobe, and Yergason tests (all, 26.7%). Ultrasound signs were commonly found at LHBT, subacromial bursa, and rotator cuff in professional bullfighters without difference between categories and sides. No side-to-side or between-categories differences were found. Positive clinical test signs suggestive of bursitis, LHBT, and rotator cuff tendinopathy were frequently observed.

Effects of worksite exercise intervention (PRODET®) on well-being at work and capability in performing work-related sedentary tasks: A pilot study.

BACKGROUND: Companies have tried to carry out interventions in order to mitigate the risks associated with losses in productivity and the health of employees. OBJECTIVE: This intervention trial evaluated the effect of a supervised exercise intervention based on aerobic capacity and strength on well-being at work and capability in performing work tasks. METHODOLOGY: The sample was composed of 67 participants (N = 67, mean age 34.31 years) and investigated a 12-week group physical exercise program in the workplace, two days per week for 50 minutes, which was supervised and based on aerobic endurance and strength. The 67 subjects were working-age office workers, deemed sedentary and randomized into an intervention (N = 40) or control (N = 27) group. Among them, 33 were men (N = 33; 49.25%) and 34 were women (N = 34, 50.75%). Outcomes were assessed pre- and post-test in both groups. The Mann-Whitney U and Chi-Square tests were performed to compare the characteristics of the intervention and control group. η2 = z/(n-1) was calculated as effect size rates. RESULTS: The program showed statistically significant effects on strength endurance (P = 0.020, η2 = 0.08), the loss of fat percentage (P = 0.015, η2 = 0.09), lower limb power (P = 0.020, η2 = 0.08) and QoL (P = 0.0001, η2 = 0.39 for the physical health outcome, and P = 0.0001, η2 = 0.35 for the outcome of total scores of mental health). CONCLUSIONS: The intervention had an impact on the endurance, fat percentage loss and QoL of the workers whose occupations were based on sedentary tasks.

The Epidemiology of Injuries in Spanish Rugby Union División de Honor.

BACKGROUND: We describe and analyze injury incidence, severity, cause of injury, anatomical location, damaged tissue, injury recurrence, and the time and place at which injuries occur over the course of a season. METHODS: An observational, descriptive, prospective, nomothetic, and multidimensional study was conducted during the 2018-2019 season with 258 players of the top semiprofessional rugby league in Spain (División de Honor de Rugby). Data were reported by the clubs' medical services. Reported time-loss injuries were collected. RESULTS: Overall exposure was 4100 h (137 matches), over 35 weeks of competition. A total of 288 injuries were reported, with three of these leading to withdrawal from the sport. A total average of 35.63 days was lost to injury. Overall time-loss injury incidence was 3.41 injuries/1000 h of exposure. Backs suffered 119 injuries corresponding to 3.80 injuries/1000 h of exposure, whilst forwards suffered 169 injuries with 4.27 injuries/1000 h of exposure. Severe injuries were the most frequent injury type. CONCLUSIONS: Outcomes confirm that more injuries take place during competition, with these also being more severe in nature. Contact injuries were most frequently suffered, above all, due to tackling or being tackled.

Muscle Recovery after a Single Bout of Functional Fitness Training.

BACKGROUND: Functional fitness training (FFT) is a new exercise modality that targets functional multi-joint actions via both muscle-strengthening exercises and aerobic training intervals. The aim of the study was to examine muscle recovery over a 20 min period after an FFT workout in trained adults. MATERIALS AND METHODS: Participants were 28 healthy trained subjects. In a single session, a countermovement jump (CMJ) was performed to determine several mechanical variables (jump height, maximum velocity, power) before (preFFT) and 4, 10, and 20 min after the FFT workout (postFFT). In parallel, capillary blood lactate concentrations were measured pre- and 3 min postFFT. Heart rate was also measured before and after the workout, and perceived exertion was measured postFFT. RESULTS: Significant differences between the time points preFFT and 4 min and 10 min postFFT, respectively, were produced in jump height (p = 0.022, p = 0.034), maximum velocity (p = 0.016, p = 0.005), average power relative (p = 0.018, p = 0.049), and average power total (p = 0.025, p = 0.049). No differences were observed in any of the variables recorded preFFT and 20 min postFFT. CONCLUSIONS: While mechanical variables indicating muscle fatigue were reduced 4 and 10 min postFFT, pre-exercise jump ability only really started to recover 20 min after FFT although not reaching pre-exercise levels. This means that ideally intervals of around 20 min of rest should be implemented between training bouts.

Pain Intensity and Sensory Perception of Tender Points in Female Patients with Fibromyalgia: A Pilot Study.

Fibromyalgia syndrome (FMS) is a condition that courses with chronic pain, fatigue, sleep disturbance, impaired quality of life and daily function. Due to the lack of blood, imaging or histological confirmatory tests, the diagnosis of FMS is based on the presence of widespread pain and presence of tender points (TPs). Our aim was to assess the pain pressure thresholds (PPTs) and subjective pain perception (SPP) of all 18 TPs while applying a normalized pressure in female patients with fibromyalgia. An exploratory descriptive pilot study was conducted in 30 female patients with FMS. Sociodemographic data (e.g., age, height, weight, and body mass index), clinical characteristics (e.g., years with diagnosis and severity of FMS), PPTs (assessed with an algometer), and SPP (assessed with a visual analogue scale) of all 18 TPs were collected. A comparative analysis side-to-side (same TP, left and right sides) and between TPs was conducted. No side-to-side differences were found (p < 0.05). Significant differences between all 18 TPs were found for PPTs (p < 0.0001), and SPP (p < 0.005) scores were found. The most mechanosensitive points were located in the second costochondral junction, the occiput, the trochanteric prominence; the most painful while applying a normalized pressure considering the TP and side were those located in the gluteus, trochanteric prominence, and supraspinatus. The current study describes PPTs and SPP, as assessed with algometry and visual analogue scale, respectively, of all 18 TPs in female patients with FMS. TPs exhibited significant PPTs and SPP differences between TP locations with no side-to-side differences.

Effects of Percutaneous Electrical Nerve Stimulation on Countermovement Jump and Squat Performance Speed in Male Soccer Players: A Pilot Randomized Clinical Trial.

It has been suggested that Percutaneous Electrical Nerve Stimulation (PENS) can increase muscle strength. No previous study has investigated changes in performance in semiprofessional soccer players. This study compares the effects of adding two sessions of PENS to a training program versus the single training program over sport performance attributes (e.g., jump height and squat speed) in healthy soccer players. A cluster-randomized controlled trial was conducted on twenty-three semiprofessional soccer players who were randomized into an experimental (PENS + training program) or control (single training program) group. The training program consisted of endurance and strength exercises separated by 15-min recovery period, three times/week. The experimental group received two single sessions of PENS one-week apart. Flight time and vertical jump height during the countermovement jump and squat performance speed were assessed before and after each session, and 30 days after the last session. Male soccer players receiving the PENS intervention before the training session experienced greater increases in the flight time, and therefore, in vertical jump height, after both sessions, but not one month after than those who did not receive the PENS intervention (F = 4.289, p = 0.003, η 2 p: 0.170). Similarly, soccer players receiving the PENS intervention experienced a greater increase in the squat performance speed after the second session, but not after the first session or one month after (F = 7.947, p < 0.001, η 2 p: 0.275). Adding two sessions of ultrasound-guided PENS before a training strength program improves countermovement jump and squat performance speed in soccer players.

Reliability and Validity of Panoramic Ultrasound Imaging for Evaluating Muscular Quality and Morphology: A Systematic Review.

Panoramic ultrasound (US) is a novel method used to assess linear dimensions, cross-sectional area, fatty infiltrate and echo-intensity features of muscles that cannot be measured with B-mode US. However, a structured overview of its validity and reliability is lacking. MEDLINE, PubMed, SCOPUS and Web of Science databases were systematically searched for studies evaluating reliability or validity data on panoramic US imaging to determine the muscular morphology and/or quality of skeletal muscles. Most studies had acceptable methodological quality. Seventeen studies analyzing reliability (n = 16) or validity (n = 5) were included. Twelve studies assessed cross-sectional area, seven studies assessed echo-intensity, five assessed linear dimensions (fascicle/tendon length, muscle/subcutaneous adipose thickness or between-structure distance) and one assessed intramuscular fat. Panoramic US seems to be a reliable and valid tool for the assessment of muscle morphology and quality in healthy populations at specific locations, particularly the lower extremities. Studies including scanning procedures are needed to confirm these findings in locations not included in this revision and in both clinical and healthy populations.

Pain and Cortisol in Patients with Fibromyalgia: Systematic Review and Meta-Analysis.

This systematic review and meta-analysis sought to gain further insight into the relationship between cortisol reactivity and chronic widespread pain in patients with fibromyalgia. The studies selected were those conducted in adults with fibromyalgia that were random controlled, non-controlled or observational. Studies were excluded if they examined diseases other than fibromyalgia or if they did not report on pain or cortisol. Twelve studies met inclusion criteria. Data were extracted into tabular format using predefined data fields by two reviewers and assessed for accuracy by a third reviewer. The methodological quality of the studies was assessed using the PEDro scale. Data Synthesis: Of 263 studies identified, 12 were selected for our review and 10 were finally included as their methodological quality was good. In the meta-analysis, we calculated effect sizes of interventions on pain indicators and cortisol levels in patients with fibromyalgia. A small overall effect of all the interventions was observed on pain tolerance and pressure pain thresholds, yet this effect lacked significance (ES = 0.150; 95%CI 0.932-1.550; p > 0.05). Conclusions: While some effects of individual nonpharmacological therapeutic interventions were observed on both cortisol levels and measures of pain, our results suggest much further work is needed to elucidate the true relationship between chronic widespread pain and cortisol levels in patients with fibromyalgia.

La influencia de la actividad física como tratamiento alternativo a la prostatitis crónica: un metaanálisis / The influence of physical activity as an alternative treatment to chronic prostatitis: a meta-analysis

INTRODUCCIÓN: La prostatitis crónica es uno de los diagnósticos más comunes en las consultas ambulatorias de Urología. Se presenta como un conjunto heterogéneo de enfermedades, cuya etiología muchas veces resulta desconocida, mostrando como denominador común un conjunto de síntomas dolorosos, irritativos y obstructivos del tracto genitourinario y el periné. OBJETIVOS: Se realizó una revisión sistemática y metaanálisis actualizado de esta dolencia en relación con los perjuicios o beneficios que la actividad física podría tener en la prostatitis crónica o el dolor pélvico crónico. MÉTODOS: Se realizó una búsqueda formal en las bases de datos Scopus, PubMed, ScienceDirect, PEDro, The Cochrane Library, Dialnet y SciELO hasta junio de 2018 (siendo el último artículo empleado en este metaanálisis publicado en marzo de 2018). RESULTADOS: El equipo investigador revisó un total de 93 estudios, de los cuales se seleccionaron 10, con un posterior examen de su calidad metodológica mediante la escala PEDro. Se realizó la comparación del índice de masa corporal, la calidad de vida relacionada con el índice de masa corporal y la correlación de la incontinencia urinaria. El análisis global de las intervenciones dentro de la incontinencia urinaria resultó significativo (tamaño del efecto: 0,11; IC 95% 0,038 a 0,43; p = 0,024). CONCLUSIONES: La variabilidad asociada a diseños experimentales representa una heterogeneidad en los efectos de los distintos programas o intervenciones de actividad física para el tratamiento de la prostatitis crónica. Los tamaños del efecto obtenidos evidencian que la efectividad de los programas de tratamiento alternativos, empleando vehicularmente la actividad física, puede guardar una relación con el tipo de intervención realizada

INTRODUCTION: Chronic prostatitis is one of the most common diagnoses in outpatient clinics in Urology. It is presented as a heterogeneous group of diseases, whose etiology is often unknown, showing as a common denominator a set of painful, irritative and obstructive symptoms of the genitourinary tract and perineum. OBJECTIVES: A systematic review and updated meta-analysis of this pathology was performed in relation to the damages or benefits that physical activity could have in chronic prostatitis or chronic pelvic pain. METHODS: The Scopus, PubMed, ScienceDirect, PEDro, The Cochrane Library, Dialnet and SciELO databases were consulted until June 2018 (the last paper used in this meta-analysis was published in March 2018). RESULTS: The research team reviewed a total of 93 studies, of which 10 were selected, with a subsequent examination of their methodological quality using the PEDro scale. The comparison of the body mass index, the quality of life related to the body mass index and the correlation of the urinary incontinence were made. The overall analysis of the interventions within the urinary incontinence was significant (effect size: 0.11; 95% CI 0.038 to 0.43; P=.024). CONCLUSIONS: The variability associated with experimental designs represents a heterogeneity in the effects of different programs or physical activity interventions for the treatment of chronic prostatitis. The effect sizes obtained suggest that the effectiveness of alternative treatment programs, using vehicular physical activity, may be related to the type of intervention performed

[The influence of physical activity as an alternative treatment to chronic prostatitis: A meta-analysis]. / La influencia de la actividad física como tratamiento alternativo a la prostatitis crónica: un metaanálisis.

INTRODUCTION: Chronic prostatitis is one of the most common diagnoses in outpatient clinics in Urology. It is presented as a heterogeneous group of diseases, whose etiology is often unknown, showing as a common denominator a set of painful, irritative and obstructive symptoms of the genitourinary tract and perineum. OBJECTIVES: A systematic review and updated meta-analysis of this pathology was performed in relation to the damages or benefits that physical activity could have in chronic prostatitis or chronic pelvic pain. METHODS: The Scopus, PubMed, ScienceDirect, PEDro, The Cochrane Library, Dialnet and SciELO databases were consulted until June 2018 (the last paper used in this meta-analysis was published in March 2018). RESULTS: The research team reviewed a total of 93 studies, of which 10 were selected, with a subsequent examination of their methodological quality using the PEDro scale. The comparison of the body mass index, the quality of life related to the body mass index and the correlation of the urinary incontinence were made. The overall analysis of the interventions within the urinary incontinence was significant (effect size: 0.11; 95% CI 0.038 to 0.43; P=.024). CONCLUSIONS: The variability associated with experimental designs represents a heterogeneity in the effects of different programs or physical activity interventions for the treatment of chronic prostatitis. The effect sizes obtained suggest that the effectiveness of alternative treatment programs, using vehicular physical activity, may be related to the type of intervention performed.

Physiotherapy Treatments in Musculoskeletal Pathologies Associated with Haemophilia.

The aim of this study is to offer physiotherapists a synthesis of the main therapeutic tools available for the treatment of musculoskeletal pathologies in patients with haemophilia, according to the scientific literature. Although bleeds are recognised as no longer being a cause of death for people with haemophilia, the accompanying musculoskeletal injuries now represent the main problem associated with this disorder. There is a lack of clear guidelines to date regarding the physiotherapy treatment of these disorders. We performed a keyword searches of Pubmed, Scopus, Sciencedirect, Cochrane and PEDro databases. In total, 555 references were retrieved, of which only 55 fulfilled the inclusion criteria. Publications were grouped by the main symptoms caused by haemophilia and the physiotherapy treatments available. The literature reviewed shows that physiotherapists have a range of therapeutic tools at their disposal for the treatment of the main musculoskeletal disorders suffered by patients with haemophilia. Physiotherapy interventions act upon inflammation and pain, as well as favouring the reabsorption of haematomas, preventing muscle fibrosis and joint ankylosis and recovering the joint range from prior to the lesions. Also, these interventions help prevent muscle atrophy and provide patients with the optimal physical conditions for facing the small and repetitive injuries that, over time, can have a detrimental effect on their quality of life. CONCLUSION: Haemophilic patients suffer from a series of musculoskeletal disorders, which are associated with important functional disability. Physiotherapy and adapted sports are essential for decreasing disability and improving the quality of life of affected patients.

Patrones de multimorbilidad, grado de control y riesgo hemorrágico en pacientes con antagonistas de la vitamina K / Multiple morbidity patterns, level of control and haemorrhagic risk in patients with vitamin K antagonists

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Biosensor amperométrico para la medida de galactosa compuesto por microgeles de poliacrilamida / Amperometric biosensor based on polyacrylamide microgels for galactose determination

La galactosemia es uno de los errores innatos del metabolismo más frecuentes. Su presentación clínica en niños no tratados puede ser severa, a veces mortal; su diagnóstico es relativamente simple y su tratamiento es muy sencillo y efectivo. Esto ha hecho que en los últimos años se hayan propuesto nuevos diseños de biosensores para la determinación de galactosa basados en galactosa oxidasa. El objetivo del trabajo consistió en la inmovilización de galactosa oxidasa (GlOx) en micropartículas de poliacrilamida (PAA), sintetizadas a partir del método de emulsión concentrada, y su utilización como material biológico de un nuevo biosensor amperométrico para la determinación de galactosa. Para preparar los biosensores de galactosa se depositaron las micropartículas con galactosa oxidasa sobre la superficie de un electrodo de platino y se cubrieron con una membrana de diálisis. Las micropartículas se caracterizaron mediante un analizador de partículas Galai Cis-1, microscopía electrónica de barrido, difracción de rayos X y calorimetría de barrido diferencial. La temperatura de transición vítrea (Tg) de los microgeles de poliacrilamida disminuyó al encapsular en su interior galactosa oxidasa. Se estudió la influencia de distintos factores, tales como grado de reticulación, pH y temperatura en la respuesta del biosensor. Las condiciones óptimas se corresponden a un grado de reticulación del 7%, 40º C y pH 7,0. El sistema de inmovilización propuesto apenas modifica la actividad enzimática, pero parece proteger a la enzima aumentando el intervalo de temperatura en el que es activa

Galactosemia is one of the natural errors of the metabolism more frequent, its clinical representation in children not treated can be severe, sometimes mortal; its diagnostic is relatively simple and its treatment is very easy and effective. Hence, in last years new biosensors design for galactose determination based on galactose oxidase has been proposed. The aim of this work consists of the immobilization of galactose oxidase (GlOx) in polyacrylamide microparticles, using the concentrated emulsion method, and their use as biological material of a new amperometric biosensor for galactose determination. For preparing the galactose biosensors, microparticles with galactose oxidase were deposited on the surface of a platinum electrode and covered with a dialysis membrane. Microparticles were characterized by a Galai Cis-1 particle analyzer system, scanning electron microscopy, X-rays diffraction and differential scanning calorimetry. The presence of galactose oxidase decreases the transition temperature (Tg) of the polyacrylamide microgels. The influence of several experimental factors, such as crosslinking content, pH and temperature, on the biosensor response was investigated. The optimal performance of the biosensor takes place for a cross-linking of 7.0%, 40ºC and pH 7.0. The proposed immobilization system almost does not modify the enzyme activity, but seems to protect to the enzyme because an increase of the temperature range in which the enzyme is active is observed