The association between sleep quality, low back pain and disability: A prospective study in routine practice.

BACKGROUND: The objective of this study was to estimate the association between sleep quality (SQ) and improvements in low back pain (LBP) and disability, among patients treated for LBP in routine practice. METHODS: This prospective cohort study included 461 subacute and chronic LBP patients treated in 11 specialized centres, 14 primary care centres and eight physical therapy practices across 12 Spanish regions. LBP, leg pain, disability, catastrophizing, depression and SQ were assessed through validated questionnaires upon recruitment and 3 months later. Logistic regression models were developed to assess: (1) the association between the baseline score for SQ and improvements in LBP and disability at 3 months, and (2) the association between improvement in SQ and improvements in LBP and disability during the follow-up period. RESULTS: Seventy-three per cent of patients were subacute. Median scores at baseline were four points for both pain and disability, as assessed with a visual analog scale and the Roland-Morris Questionnaire, respectively. Regression models showed (OR [95% CI]) that baseline SQ was not associated with improvements in LBP (0.99 [0.94; 1.06]) or in disability (0.99 [0.93; 1.05]), although associations existed between 'improvement in SQ' and 'improvement in LBP' (4.34 [2.21; 8.51]), and 'improvement in SQ' and 'improvement in disability' (4.60 [2.29; 9.27]). CONCLUSIONS: Improvement in SQ is associated with improvements in LBP and in disability at 3-month follow-up, suggesting that they may reflect or be influenced by common factors. However, baseline SQ does not predict improvements in pain or disability. SIGNIFICANCE: In clinical practice, sleep quality, low back pain and disability are associated. However, sleep quality at baseline does not predict improvement in pain and disability.

Effects of vibration therapy on hormone response and stress in severely disabled patients: a double-blind randomized placebo-controlled clinical trial.

PURPOSE: To assess the effects of vibration therapy (VT) on quality of life and hormone response in severely disabled patients compared with placebo. DESIGN: A longitudinal prospective, double-blind, randomized placebo-controlled trial, with pre and postintervention assessments. METHODS: A total of 20 severely disabled individuals were recruited from a National Reference Centre in Spain: 13 (65%) men and 7 (35%) women, 45.5 ± 9.32 years of age (range 41: 22-63). We evaluated their physical stress and state anxiety. RESULTS: No statistically significant changes were found in the socio-psychological variables studied, while in the experimental group state anxiety decreased significantly with p < 0.01 (Z = 2.38; one-tailed p = .009) and, among the biological variables, the level of cortisol fell (p = 0.03). CONCLUSION: Short periods of exposure to low-frequency and low-amplitude local vibration are a safe and effective mechanical stimulus that can have a positive effect in terms of hormone response. CLINICAL RELEVANCE: VT can be considered to have an anti-stress effect.

Incidencia de la perforación de los guantes en cirugía y efecto protector del doble guante / Glove perforation in surgery and protective effect of double gloves

Objetivo. Estudiar la incidencia de perforaciones en los guantes en cirugía programada comparando la proporción de punciones entre el guante simple y el doble guante. Evaluar la proporción de estas punciones que permanecen inadvertidas. Método. Ensayo clínico, aleatorizado y controlado de un año de duración realizado en 2008 durante las cirugías programadas en los quirófanos del Hospital Universitario de Canarias. Se estudiaron los guantes simples y dobles (interno y externo), llevados por cirujanos, ayudantes y enfermeras instrumentistas. Los guantes se midieron durante 3min con el método estandarizado de «Fuga de Agua» (EN455-1) al finalizar la cirugía para detectar fugas. Resultados. En 113 cirugías se evaluaron 1.537 guantes, ocurriendo 7 perforaciones advertidas y 104 inadvertidas, la mayor parte en cirugías mayores. De las punciones inadvertidas, 43 (41,3%) ocurrieron en guantes simples, 51 (49%) en guantes exteriores del doble enguantado y 10 (9,6%) en los guantes internos. La proporción de perforación de los guantes en los cirujanos 9,85%, resultó ligeramente mayor que en las enfermeras 6,91%, pero significativamente mayor que en los ayudantes 4,04% (p<0,001). Conclusiones. Se concluye que el doble guante es efectivo en cirugía pues la barrera protectora es mantenida por el guante interno en cuatro de cada cinco casos en que el guante externo es perforado inadvertidamente. A pesar de la posible incomodidad y reducción de sensibilidad, debe tenerse en cuenta la efectividad del enguantado doble como barrera protectora(AU)

Objective. To investigate the incidence of glove perforation in programmed surgery and compare perforation rates between single-gloves and double-gloves. To evaluate the extent to which glove perforations remain undetected during surgery. Method. Randomized and controlled trial. A one year of study period in 2008 consisting of programmed surgeries at the Canary Islands University Hospital. Gloves, randomized into single or double, worn by surgeons, assistants and scrub nurses were analyzed using the Water Leak Test (EN455-1) for 3min after surgery ended to detect leakage. Results. A total of 1537 gloves were examined during 113 operations, 7 perforations were noticed during the operation and 104 unnoticed, especially in mayor surgery. Of these, 43 perforations (41.3%) occurred while wearing single gloves and 51 (49%) in the outer of a double glove. Only 10 perforations (9.6%) were found in the inner glove. The perforation rate for surgeons was 9.85%, were slightly greater than nurses at 6,91%, but significantly greater that the rate for assistants, 4,04% (p<0.001). Conclusions. We conclude that double gloving is effective in surgery, in as much as the barrier protection was maintained by the inner glove in four out of five cases when the outer glove was inadvertently perforated. Surgical teams must balance the improved safety of double gloving with the possible discomfort and reduced sensitivity (AU)

[Glove perforation in surgery and protective effect of double gloves]. / Incidencia de la perforación de los guantes en cirugía y efecto protector del doble guante.

OBJECTIVE: To investigate the incidence of glove perforation in programmed surgery and compare perforation rates between single-gloves and double-gloves. To evaluate the extent to which glove perforations remain undetected during surgery. METHOD: Randomized and controlled trial. A one year of study period in 2008 consisting of programmed surgeries at the Canary Islands University Hospital. Gloves, randomized into single or double, worn by surgeons, assistants and scrub nurses were analyzed using the Water Leak Test (EN455-1) for 3 min after surgery ended to detect leakage. RESULTS: A total of 1537 gloves were examined during 113 operations, 7 perforations were noticed during the operation and 104 unnoticed, especially in mayor surgery. Of these, 43 perforations (41.3%) occurred while wearing single gloves and 51 (49%) in the outer of a double glove. Only 10 perforations (9.6%) were found in the inner glove. The perforation rate for surgeons was 9.85%, were slightly greater than nurses at 6,91%, but significantly greater that the rate for assistants, 4,04% (p<0.001). CONCLUSIONS: We conclude that double gloving is effective in surgery, inasmuch as the barrier protection was maintained by the inner glove in four out of five cases when the outer glove was inadvertently perforated. Surgical teams must balance the improved safety of double gloving with the possible discomfort and reduced sensitivity.

Epidemiología de las lesiones deportivas / Epidemiology of sports injuries

La epidemiología de las lesiones deportivas es el estudio de la distribución y las variables que intervienen en la aparición de lesiones en grupos de población, con el propósito de establecer medidas de prevención. Este artículo pretende revisar de un modo general y fácil de entender la distribución y los factores lesionales publicados en la literatura, completados con nuestra propia experiencia. En nuestro medio, la mayoría de las lesiones ocurren en la práctica del fútbol, seguido del baloncesto y fútbol sala y afectan a las extremidades inferiores, especialmente a la rodilla. Se presentan, sobre todo, entre los 15 y los 25 años y afectan más a los hombres. Las lesiones ligamentosas y las musculares son las más frecuentes

Sport injury epidemiology is the study of the distribution and determinants of varying rates of injuries in human populations for the purpose of stablishing procedures to prevent their occurrence. This article review integratively and comprehensively the distribution and determinants of injury rates as reported in the literature in addition our experiencie. The largest injury rates is in soccer, followed the basketball and indoor soccer, injuried lower extremities, knee highest. Sports injuries are more frequent in young people, 15-25 years of age. Sprains and straints are the most common injuries (AU)

Tratamiento y valoración del equilibrio mediante estabilometría en jugador de baloncesto en silla de ruedas. A propósito de un caso / Treatment and evaluation of equilibrium through stabilometry in dishandicapped basketball player. A case study

El presente trabajo realiza un estudio sobre la posible mejora del equilibrio en un sujeto parapléjico (síndrome de lesión medular completa a nivel de D5), que juega al baloncesto, por medio del entrenamiento en una plataforma de equilibrio. Entre los objetivos de trabajo se propone mejorar el equilibrio del sujeto en silla de ruedas para la mejora de la práctica del baloncesto; mejorar el control del tronco, tanto en el eje lateral como en el anteroposterior, y la estabilidad de la cintura escapular. Los resultados demuestran una mejora en equilibrio, tras realización del tratamiento, aunque sólo con los ojos abiertos. Se concluye que el uso de estabilometría refuerza las aferencias visuales, compensando la pérdida de aferencias propioceptivas que ha sufrido el sujeto. Se propone la utilización de un sistema de trabajo que, además de mejorar el equilibrio, nos aporte datos objetivos y cuantificables en la mejora del mismo

This study evaluates the possible improvement on the balance of a paraplegic patient (D5 complete traumatic injury of spinal cord), who plays basketball, through training on a balance platform. One of the main purposes of this study is the improvement of balance of the patient on the wheelchair to get a better performance on his game, improve control of torso, in both lateral and anterior posterior axis and also stability of the scapular girdle. Results shows improvement of balance after treatment, though, with open eyes only. This data could lead us to the following conclussion: stabilometry does improve visual inputs, stepping up lost of propioceptive inputs. We propose the usage of a working system that allows balance improvement and also provides objective and quantifiable data of such improvement

Efectos de la Vibroterapia sobre la actividad eléctrica del músculo fatigado / Effects of vibrotherapy on electrical activity of the fatigued muscle

En el presente trabajo se expone el estudio realizado en un equipo femenino de jugadoras de baloncesto de alta competición, en el que tratamos de probar la eficacia de una técnica de fisioterapia, la Vibroterapia, sobre el músculo fatigado. La Vibroterapia se ha aplicado por medio de un sistema mecánico denominado máquina de relajación muscular (MRM®). También se ha valorado la actividad eléctrica de los músculos vasto interno y bíceps femoral, antes y después de la aplicación de dicha técnica, a través de electromiografía de superficie. Se realiza además la valoración de la sensación subjetiva de la relajación producida por la misma, mediante la administración de un cuestionario

This study was carried out on a professional team basketball women players. It deals with the efficiency of a pysiotherapy tecnique, a vibratory sistem, on fatigue muscles.This vibratory sistem was applied through a mecanical sistem called MRM (Muscular Relaxation Mecanism). This study also evaluates electrical muscle activity of vastus internus and biceps femori, before and after de aplication of the tecnique. Finally, it evaluates the subjetive relaxation, though a physcological test