Family Involvement and at-Home Physical Therapy on Duchenne Muscular Dystrophy: A Randomized Controlled Trial.

BACKGROUND: Duchenne muscular dystrophy (DMD) is a genetic condition that causes muscle weakness and begins in early childhood. To treat its complications, the rehabilitation program includes physical therapy, mainly on the musculoskeletal and the respiratory complications that appear on the evolution of the disease. This study aims to explore the effects of physical therapy with or without an at-home program on motor function among children with DMD. METHODS: A randomized controlled trial was carried out for one year (one group with at-home and conventional physical therapy and another with conventional physical therapy). Motor function was measured using the Motor Function Measure (MFM) scale, the Vignos and Brooke scales, the Timed-up-and-Go test, and the six-minute walk distance test. RESULTS: Twenty-seven participants with DMD participated in this study. In the at-home and conventional physical therapy group, better motor function at the distal and global level was maintained, per the results of the MFM scale (P < 0.05). The rest of the variables did not achieve statistically significant changes. CONCLUSIONS: Our results suggest that complementing conventional treatment with at-home treatment in which the family is involved maintains better motor function, in participants with DMD.

Effect of physical therapy on bone remodelling in preterm infants: a multicenter randomized controlled clinical trial.

BACKGROUND: Preterm infants have a low level of bone mineralization compared to those born at term, since 80% of calcium incorporation occurs at the end of pregnancy. The purpose of the present study was to investigate the effect of reflex locomotion therapy on bone modeling and growth in preterm infants and to compare its effect with those of other Physiotherapy modalities. METHODS: A multicentre randomized controlled clinical trial was conducted (02/2016 - 07/2020). 106 preterm infants born at the Virgen de la Arrixaca University Clinical Hospital, the General University Hospital of Elche and the Torrecárdenas University Hospital of Almería, between 26 and 34 weeks with hemodynamic stability, complete enteral nutrition and without any metabolic, congenital, genetic, neurological or respiratory disorders were evaluated for inclusion. Infants were randomly assigned to three groups: one group received reflex locomotion therapy (EGrlt); another group received passive mobilizations with gentle joint compression (EGpmc); and the control group received massage (CG). All treatments were carried out in the neonatal units lasting one month. The main outcome measure was bone formation and resorption measured with bone biomarkers. A mixed ANOVA was used to compare the results of bone biomarkers, and anthropometric measurements. RESULTS: Infants were randomized to EGrlt (n = 38), EGpmc (n = 32), and CG (n = 36). All groups were similar in terms of gender (p = 0.891 female 47.2%), gestational age (M = 30.753, SD = 1.878, p = 0.39) and birth weight (M = 1413.45, SD = 347.36, p = 0.157). At the end of the study, significant differences were found between the groups in their interaction in bone formation, measured with osteocalcin [F (2,35) = 4.92, p = 0.013, ηp2 = 0.043], in benefit of the EGrlt. CONCLUSIONS: Reflex locomotion therapy has been effective in improving bone formation, more so than other Physiotherapy modalities. Therefore, reflex locomotion therapy could be considered one of the most effective physiotherapeutic modalities for the prevention and treatment of osteopenia of prematurity. TRIAL REGISTRSTION: Trial retrospectively registered at ClinicalTrials.gov. First posted on 22/04/2020. REGISTRATION NUMBER: NCT04356807 .

Short-term effects of a manual therapy protocol on pain, physical function, quality of sleep, depressive symptoms, and pressure sensitivity in women and men with fibromyalgia syndrome: a randomized controlled trial.

OBJECTIVE: To investigate the therapeutic effects of a manual therapy protocol for improving pain, function, pressure pain thresholds (PPT), quality of sleep, and depressive symptoms in women and men with fibromyalgia syndrome (FMS). MATERIALS AND METHODS: Eighty-nine patients were randomly assigned to experimental or control group. The experimental group (24 female, 21 male) received 5 sessions of manual therapy and the control group (24 female, 21 male) did not receive any intervention. PPT, pain, impact of FMS symptoms, quality of sleep, and depressive symptoms were assessed in both groups at baseline and after 48 hours of the last intervention in the experimental group. RESULTS: The analysis of covariance found significant Group×Time×Sex interactions for McGill PPI and Center for Epidemiologic Studies Depressive Symptoms Scale (P<0.01) was also found: men exhibited a larger effect size for depressive symptoms than women, whereas women exhibited a greater effect size than men in the McGill PPI. A significant Group×Time×Sex interaction for PPT over suboccipital, upper trapezius, supraspinatus, second rib, gluteal region, and tibialis anterior muscle was also found: men included in the experimental group experienced significant greater improvements in PPT as compared with women with FMS in the experimental group. CONCLUSIONS: Manual therapy protocol was effective for improving pain intensity, widespread pressure pain sensitivity, impact of FMS symptoms, sleep quality, and depressive symptoms. In addition, sex differences were observed in response to treatment: women and men get similar improvements in quality of sleep and tender point count, whereas women showed a greater reduction in pain and impact of FMS symptoms than men, but men reported higher decreases in depressive symptoms and pressure hypersensitivity than women.

Benefits of starting rehabilitation within 24 hours of primary total knee arthroplasty: randomized clinical trial.

OBJECTIVE: To compare the benefits of initiating rehabilitation treatment within 24 hours versus 48-72 hours after total knee arthroplasty for osteoarthritis. DESIGN: Experimental study with clinical trial design. SUBJECTS: Patients undergoing primary total knee arthroplasty for osteoarthritis were randomly assigned to experimental (n = 153) and control (n = 153) groups. INTERVENTIONS: Rehabilitation was started within 24 hours post surgery in the experimental group and between 48 hours and 72 hours post surgery in the controls. MAIN MEASURES: Measurement variables included joint range of motion, muscle strength, pain, autonomy, gait and balance. RESULTS: In comparison with the controls, the experimental group showed significantly shorter hospital stay (by (mean ± standard deviation) 2.09 ± 1.45 days; P < 0.001), fewer rehabilitation sessions until medical discharge (by 4.95 ± 2.34; P < 0.001), lesser pain (by 2.36 ± 2.47 points; P < 0.027), greater joint range of motion in flexion (by 16.29 ± 11.39 degrees; P < 0.012) and extension (by 2.12 ± 3.19; P < 0.035), improved strength in quadriceps (by 0.98 ± 0.54; P < 0.042) and hamstring muscles (by 1.05 ± 0.72; P < 0.041), and higher scores for gait (P < 0.047) and balance (P < 0.045). CONCLUSION: Initiation of rehabilitation within 24 hours after total knee arthroplasty reduces the mean hospital stay and number of sessions required to achieve autonomy and normal gait and balance.

Eficacia de un programa de masaje y ejercicio sobre el índice tobillo/brazo y presión sanguínea en pacientes con diabetes mellitus tipo 2 y enfermedad arterial periférica: ensayo clínico aleatorizado / Efficacy of a massage and exercise programme on the ankle-brachial index and blood pressure in patients with diabetes mellitus type 2 and peripheral arterial disease: a randomized clinical trial

Fundamento y objetivo: La diabetes mellitus tipo 2 es una enfermedad con una elevada prevalencia y puede favorecer la aparición de enfermedad arterial periférica. El objetivo del presente estudio fue analizar la eficacia de un programa de ejercicios y masaje reflejo del tejido conjuntivo sobre el índice tobillo/brazo y los valores de presión arterial de pacientes con diabetes mellitus tipo 2 y enfermedad arterial periférica. Pacientes y método: Se realizó un estudio experimental con grupo control placebo. Se asignaron de forma aleatorizada 66 pacientes diabéticos tipo 2 con enfermedad arterial periférica en estadio II-b de Leriche-Fontaine a un grupo de intervención (ejercicio y masaje) y a un grupo control placebo (programa de magnetoterapia simulada). Las dimensiones de medida fueron la presión arterial e índice tobillo/brazo. Resultados: Finalizadas las 10 semanas de tratamiento, en el grupo de intervención se obtuvieron diferencias significativas (p<0,05) en el índice tobillo/brazo derecho e izquierdo y en la presión arterial sistólica y diastólica en el miembro inferior derecho e izquierdo. Conclusiones: Un programa combinado de ejercicios y masaje mejora la presión arterial y el índice tobillo/brazo en pacientes diabéticos tipo 2 con enfermedad arterial periférica (AU)

Background and Objective: Type 2 diabetes mellitus is a highly prevalent disease that can favour the development of peripheral arterial disease. The objective of this study was to analyse the efficacy of a massage and exercise programme on the ankle-brachial index and arterial pressure of patients with diabetes mellitus type 2 and peripheral arterial disease. Material and Methods: An experimental study with placebo control group was performed. Sixty-six type 2 diabetes patients with Leriche-Fontaine stage II peripheral arterial disease were randomly assigned to an intervention (exercise and massage) or placebo control (simulated magnetotherapy) group. Study variables were arterial pressure and ankle-brachial index. Results: After 10 weeks of treatment, significant (P<0.05) differences between the intervention and placebo groups were found in right and left ankle-brachial index values and in systolic and diastolic pressures in right and left lower extremities. Conclusions: A combined programme of exercise and massage improves arterial blood pressure and ankle brachial index values in type 2 diabetics with peripheral arterial disease (AU)

[Efficacy of a massage and exercise programme on the ankle-brachial index and blood pressure in patients with diabetes mellitus type 2 and peripheral arterial disease: a randomized clinical trial]. / Eficacia de un programa de masaje y ejercicio sobre el índice tobillo/brazo y presión sanguínea en pacientes con diabetes mellitus tipo 2 y enfermedad arterial periférica: ensayo clínico aleatorizado.

BACKGROUND AND OBJECTIVE: Type 2 diabetes mellitus is a highly prevalent disease that can favour the development of peripheral arterial disease. The objective of this study was to analyse the efficacy of a massage and exercise programme on the ankle-brachial index and arterial pressure of patients with diabetes mellitus type 2 and peripheral arterial disease. MATERIAL AND METHODS: An experimental study with placebo control group was performed. Sixty-six type 2 diabetes patients with Leriche-Fontaine stage II peripheral arterial disease were randomly assigned to an intervention (exercise and massage) or placebo control (simulated magnetotherapy) group. Study variables were arterial pressure and ankle-brachial index. RESULTS: After 10 weeks of treatment, significant (P<0.05) differences between the intervention and placebo groups were found in right and left ankle-brachial index values and in systolic and diastolic pressures in right and left lower extremities. CONCLUSIONS: A combined programme of exercise and massage improves arterial blood pressure and ankle brachial index values in type 2 diabetics with peripheral arterial disease.