ABSTRACT
BACKGROUND: Fibromyalgia syndrome (FM) is a chronic pathology characterised by widespread pain commonly associated with psychological distress affecting quality of life. In recent years, transcranial direct current stimulation (tDCS) and transcranial magnetic stimulation (TMS) have been investigated to treat chronic pain. The aim of the current review is to determine the effects of tDCS and TMS on the main symptoms of patients with FM. DEVELOPMENT: A systematic review based on PRISMA guidelines was carried out. The search strategy was performed in MEDLINE, SCOPUS, PEDro and Cochrane Library. Randomised controlled trials based on the effects of tDCS and TMS on pain, pressure pain threshold (PPT), fatigue, anxiety and depression, catastrophising and quality of life in patients with FM were analysed. Fourteen studies were included. CONCLUSIONS: The application of tDCS to the motor cortex is the only intervention shown to decrease pain in the short and medium-term in patients with FM. The application of both interventions showed improvements in PPT, catastrophising and quality of life when applied to the motor cortex, and in fatigue when applied to the dorsolateral prefrontal cortex. The effects of these interventions on anxiety and depression are unclear.
Subject(s)
Chronic Pain , Fibromyalgia , Transcranial Direct Current Stimulation , Humans , Transcranial Magnetic Stimulation , Fibromyalgia/therapy , Fibromyalgia/psychology , Quality of Life , Chronic Pain/therapy , Fatigue/therapyABSTRACT
Objetivo: Comparar el rango de movimiento y la extensibilidad entre el brazo lanzador y no lanzador en jugadores de balonmano y correlacionar el tiempo de práctica deportiva con la extensibilidad, el rango de movimiento (ROM) y la intensidad de los síntomas durante el gesto de lanzamiento. Métodos: Se realizó un estudio transversal en el que se incluyeron 43 jugadores de balonmano semiprofesionales. Se valoró el tiempo de práctica deportiva, la extensibilidad de los tejidos de la parte posterior, el ROM de rotación interna y externa y la intensidad del dolor durante el gesto de lanzamiento. Resultados: El brazo lanzador presentó un menor ROM de rotación interna y extensibilidad de los tejidos de la parte posterior (p<0,05), así como un mayor ROM de rotación externa (p=0,044). Se encontraron correlaciones negativas moderadas entre los años de práctica deportiva y el ROM de rotación interna (p=0,011) y la extensibilidad de los tejidos de la parte posterior (p=0,033). También se encontró una correlación positiva moderada entre el ROM de rotación interna y la extensibilidad de los tejidos de la parte posterior (p=0,002). No se encontraron correlaciones con la intensidad del dolor (p>0,05). Conclusiones: El brazo lanzador presenta un menor ROM de rotación interna, un mayor ROM de rotación externa y una menor extensibilidad. La disminución del ROM de rotación interna se ha mostrado asociado con la extensibilidad, y tanto el ROM de rotación interna como la extensibilidad se han mostrado asociados con el tiempo de práctica deportiva.(AU)
Objective: To compare range of motion and extensibility between the throwing shoulder and non-throwing shoulder in handball athletes. To investigate the relationship between the time practicing handball with the extensibility, the range of motion (ROM) and shoulder pain intensity during throwing actions. Methods: A cross-sectional study was carried out. Forty-three semi-professional handball athletes were included. The time practicing handball, the extensibility of the tissues of the posterior part of the shoulder, the internal rotation and external rotation ROM and pain intensity during throwing actions were assessed. Results: The throwing shoulder presented a decreased in internal rotation ROM and extensibility of the tissues of the posterior part of the shoulder (P<.05), and a greater external rotation ROM (P=.044). Moderate negative associations were found between the time practicing handball and internal rotation ROM (P=.011) and the extensibility of the tissues of the posterior part of the shoulder (P=.033). A positive moderate association was found between internal rotation ROM and extensibility of the tissues of the posterior part of the shoulder (P=.002). No associations were found with pain intensity (P>.05). Conclusions: The throwing shoulder presents a lesser internal rotation ROM, a greater external rotation ROM and a lack of extensibility. The internal rotation ROM deficit has been associated with the extensibility, and both variables have been associated with the time of practicing handball. (AU)
Subject(s)
Humans , Male , Young Adult , Shoulder Pain , Range of Motion, Articular , SportsABSTRACT
INTRODUCTION: Fibromyalgia syndrome (FM) is a chronic pathology characterized by widespread pain commonly associated with psychological distress affecting quality of life. In recent years, transcranial direct current stimulation (tDCS) and transcranial magnetic stimulation (TMS) have been investigated to treat chronic pain. The aim of the current review is to determine the effects of tDCS and TMS on the main symptoms of patients with FM. DEVELOPMENT: A systematic review based on PRISMA guidelines was carried out. The search strategy was performed in Medline, Scopus, PEDro and Cochrane Library. Randomized controlled trials based on the effects of tDCS and TMS on pain, pressure pain threshold, fatigue, anxiety and depression, catastrophizing and quality of life in patients with FM were analysed. Fourteen studies were included. CONCLUSIONS: The application of tDCS to the motor cortex is the only intervention shown to decrease pain in the short and medium-term in patients with FM. The application of both interventions showed improvements in pressure pain threshold, catastrophizing and quality of life when applied to the motor cortex, and in fatigue when applied to the dorsolateral prefrontal cortex. The effects of these interventions on anxiety and depression are unclear.
ABSTRACT
INTRODUCCIÓN: El síndrome del túnel carpiano (STC) es la neuropatía periférica más común. Consiste en la compresión del nervio mediano a nivel de túnel carpiano. Tiene una alta prevalencia y genera una situación muy discapacitante desde las primeras fases. En los casos graves el tratamiento suele ser quirúrgico, mientras que en los leves y moderados el tratamiento es conservador. El objetivo de esta revisión es conocer los tratamientos conservadores, así como su efectividad, en pacientes con STC leve y moderado, en los 15 últimos años. DESARROLLO: Se realizó una revisión sistemática según los criterios de PRISMA. Se emplearon las bases de datos Medline, PEDro y Cochrane. Se seleccionaron aquellos ensayos clínicos controlados y aleatorizados que analizasen los efectos del tratamiento conservador sobre los síntomas y la función en pacientes con STC leve o moderado. Se incluyeron 32 ensayos clínicos. Existe evidencia sobre la efectividad de los fármacos orales aunque las infiltraciones parecen ser más efectivas. El uso de férulas ha mostrado ser efectivo y asociado a otras técnicas no farmacológicas también. Las técnicas de electroterapia no han mostrado resultados concluyentes sobre la efectividad de forma aislada. Otras técnicas de tejido blando también han mostrado buenos resultados pero es escasa la evidencia en este campo. También se han propuesto varias combinaciones de tratamiento farmacológico con no farmacológico sin resultados concluyentes. CONCLUSIONES: Existen varios tratamientos conservadores capaces de mejorar los síntomas y la función de los pacientes con STC leve y moderado. Estos incluyen el uso de férulas, fármacos orales, infiltraciones, técnicas de electroterapia, técnicas manuales específicas y ejercicios de deslizamiento neural, así como la combinación de varias de ellas. No ha sido posible describir la mejor técnica o combinación de técnicas debido a las limitaciones de los estudios, por lo que es necesario realizar más estudios con una calidad metodológica adecuada
BACKGROUND: Carpal tunnel syndrome (CTS) is the most common peripheral neuropathy. It is characterised by the compression of the median nerve in the carpal tunnel. CTS presents a high prevalence and it is a disabling condition from the earliest stages. Severe cases are usually treated surgically, while conservative treatment is recommended in mild to moderate cases. The aim of this systematic review is to present the conservative treatments and determine their effectiveness in mild-to-moderate cases of CTS over the last 15 years. METHODS: A systematic review was performed according to PRISMA criteria. We used the Medline, PEDro, and Cochrane databases to find and select randomised controlled clinical trials evaluating the effects of conservative treatment on the symptoms and functional ability of patients with mild to moderate CTS; 32 clinical trials were included. There is evidence supporting the effectiveness of oral drugs, although injections appear to be more effective. Splinting has been shown to be effective, and it is also associated with use of other non-pharmacological techniques. Assessments of the use of electrotherapy techniques alone have shown no conclusive results about their effectiveness. Other soft tissue techniques have also shown good results but evidence on this topic is limited. Various treatment combinations (drug and non-pharmacological treatments) have been proposed without conclusive results. CONCLUSIONS: Several conservative treatments are able to relieve symptoms and improve functional ability of patients with mild-to-moderate CTS. These include splinting, oral drugs, injections, electrotherapy, specific manual techniques, and neural gliding exercises as well as different combinations of the above. We have been unable to describe the best technique or combination of techniques due to the limitations of the studies; therefore, further studies of better methodological quality are needed
Subject(s)
Humans , Carpal Tunnel Syndrome/therapy , Conservative Treatment/methods , Randomized Controlled Trials as Topic , Physical Therapy Modalities , Treatment OutcomeABSTRACT
BACKGROUND: Carpal tunnel syndrome (CTS) is the most common peripheral neuropathy. It is characterised by the compression of the median nerve in the carpal tunnel. CTS presents a high prevalence and it is a disabling condition from the earliest stages. Severe cases are usually treated surgically, while conservative treatment is recommended in mild to moderate cases. The aim of this systematic review is to present the conservative treatments and determine their effectiveness in mild-to-moderate cases of CTS over the last 15 years. METHODS: A systematic review was performed according to PRISMA criteria. We used the Medline, PEDro, and Cochrane databases to find and select randomised controlled clinical trials evaluating the effects of conservative treatment on the symptoms and functional ability of patients with mild to moderate CTS; 32 clinical trials were included. There is evidence supporting the effectiveness of oral drugs, although injections appear to be more effective. Splinting has been shown to be effective, and it is also associated with use of other non-pharmacological techniques. Assessments of the use of electrotherapy techniques alone have shown no conclusive results about their effectiveness. Other soft tissue techniques have also shown good results but evidence on this topic is limited. Various treatment combinations (drug and non-pharmacological treatments) have been proposed without conclusive results. CONCLUSIONS: Several conservative treatments are able to relieve symptoms and improve functional ability of patients with mild-to-moderate CTS. These include splinting, oral drugs, injections, electrotherapy, specific manual techniques, and neural gliding exercises as well as different combinations of the above. We have been unable to describe the best technique or combination of techniques due to the limitations of the studies; therefore, further studies of better methodological quality are needed.
Subject(s)
Carpal Tunnel Syndrome/therapy , Conservative Treatment/methods , Humans , Randomized Controlled Trials as Topic , Treatment OutcomeABSTRACT
INTRODUCTION: Functional electrical stimulation is one of the physiotherapy techniques used today for the management of patients who have suffered a stroke. AIM: To determine the effectiveness of the functional electrical stimulation in general skills, gait, general capacities and quality of stroke patients through a systematic review. Also has secondary objective was raised to know the best method of application of this technique. PATIENTS AND METHODS: We performed a literature search in Medline, PEDro and Cochrane Library. Clinical trials and systematic reviews about the effectiveness of the functional electrical stimulation in stroke patients from last five years were included. RESULTS: Ten clinical trials and one systematic review were included and we analyzed and compared the most relevant data extracted of them. CONCLUSIONS: Functional electrical stimulation shows an improvement in the quality of life, motor abilities and gait in stroke patients. It is more effective associated with other physiotherapy techniques. Functional electrical stimulation alone does not provide better results than other physiotherapy techniques. The implementation of the technique in more than one muscle group, triggering impulses by active movements and associating with other interventions, is the best approach to application of functional electrical stimulation.
TITLE: Efectividad de la electroestimulacion funcional en pacientes con ictus: revision sistematica.Introduccion. La electroestimulacion funcional es una de las tecnicas fisioterapicas empleadas en la actualidad para el abordaje de los pacientes que han sufrido un ictus. Objetivo. Conocer la efectividad de la electroestimulacion funcional en las capacidades generales, la marcha y la calidad de vida de los pacientes con ictus mediante una revision sistematica. Como objetivo secundario se planteo conocer el mejor metodo de aplicacion de esta tecnica. Pacientes y metodos. Se ha realizado una busqueda bibliografica en las bases de datos Medline, PEDro y Biblioteca Cochrane. Se han incluido ensayos clinicos y revisiones sistematicas de los ultimos cinco años que valorasen la efectividad de la electroestimulacion funcional en pacientes tras sufrir un ictus. Resultados. Se incluyeron 10 ensayos clinicos y una revision sistematica con metaanalisis, de los cuales se extrajeron los datos mas relevantes, se analizaron y se compararon. Conclusiones. La electroestimulacion funcional puede ayudar en la mejora de la calidad de vida, las capacidades motoras y la funcionalidad de la marcha en pacientes que han sufrido un ictus. No se puede afirmar que por si sola aporte mejores resultados que otras tecnicas convencionales de fisioterapia, y se observa una mayor efectividad con la aplicacion de electroestimulacion funcional asociada a otras tecnicas de fisioterapia. El mejor abordaje de la aplicacion con electroestimulacion funcional es el realizado en mas de un grupo muscular, desencadenando los impulsos mediante movimientos activos y en combinacion con otras intervenciones fisioterapicas.
