Benefits of Music Therapy in the Cognitive Impairments of Alzheimer's-Type Dementia: A Systematic Review.

Background/Objective: Alzheimer's disease is a condition that can cause memory, thinking, and behaviour impairments. This type of dementia affects approximately 50 million people globally. Currently, there is no remedy for this disease, but there are different treatment approaches, both pharmacological and non-pharmacological, that try to alleviate the symptoms. The remarkable fact about Alzheimer's response to music is that musical abilities can be preserved even though language could be lost. The objective of this systematic review is to assess the benefits of music therapy on cognitive impairments in older adults with Alzheimer's disease. Methods: This is a systematic review carried out following the PRISMA guidelines. The literature searches were conducted in the following databases: PubMed, SCOPUS, Cochrane Library, and Dialnet. The inclusion criteria established were as follows: randomised controlled studies and clinical trials published in English and Spanish from 2010 to 2024, patients diagnosed with dementia of the Alzheimer's type, aged 65 years or older, who had participated in music interventions and had cognitive changes. Results: Eleven studies were included in this review. They showed that music therapy interventions mainly improved memory, language, and orientation. The results of a methodological quality analysis showed that six of the articles had good methodological quality and four had excellent methodological quality. Conclusions: The results of this review suggest that treatment with music therapy improves cognitive impairments in patients with Alzheimer's disease. In addition, we can be sure that music creates a link between the patient and the specialist.

Circulating serotonin and dopamine concentrations in osteoarthritis patients: a pilot study on the effect of pelotherapy.

Balneotherapy has demonstrated clinical efficacy in the management of pathologies involving low-grade inflammation and stress. In rheumatic conditions such as osteoarthritis (OA), this therapy presents anti-inflammatory properties and potential to improve psychological well-being. Although the neurohormones serotonin and dopamine are known to be involved in these processes, surprisingly they have not been studied in this context. The objective was to evaluate the effect of a cycle of balneotherapy with peloids (pelotherapy) on circulating serotonin and dopamine concentrations in a group of aged individuals with OA, after comparing their basal state to that of an age-matched control group. In our pilot study, a pelotherapy program (10 days) was carried out in a group of 16 elderly patients with OA, evaluating its effects on circulating serotonin and dopamine concentrations (measured by ELISA). Individuals with OA showed higher levels of serotonin and lower dopamine levels, in line with the inflammatory roles of these mediators. After pelotherapy, serotonin concentrations significantly decreased, potentially contributing to the previously reported anti-inflammatory effects of balneotherapy.

Effects of Virtual Reality in the Rehabilitation of Parkinson's Disease: A Systematic Review.

BACKGROUND: Parkinson's disease is characterised by the loss of balance and the presence of walking difficulties. The inclusion of rehabilitation therapies to complement pharmacological therapy allows for comprehensive management of the disease. In recent years, virtual reality has been gaining importance in the treatment of neurological diseases and their associated symptoms. Therefore, the objective of this systematic review was to analyse the effectiveness of virtual reality on balance and gait in patients with Parkinson's disease. METHODS: This study is a systematic review conducted following PRISMA's statements. An electronic search of the literature was carried out in the following databases: PubMed, Cochrane, Dialnet, Scopus, Web of Science, PsycINFO and Science Direct PEDro. The inclusion criteria were controlled and non-controlled clinical trials published in the last 12 years in English or Spanish, in which virtual reality was applied to treat balance and gait impairments in patients with Parkinson's disease. RESULTS: 20 studies were finally included in this review. A total of 480 patients participated in the included studies. All patients were diagnosed with Parkinson's disease. Most of the investigations used the Nintendo Wii + Balance Board or the Microsoft Kinect TM combined with the Kinect Adventures games as a virtual reality device. CONCLUSIONS: According to the results of this literature review, virtual reality-based interventions achieve good adherence to treatment, bring innovation and motivation to rehabilitation, and provide feedback as well as cognitive and sensory stimulation in patients with Parkinson's disease. Therefore, virtual reality can be considered an alternative for personalised rehabilitation and for home treatment.

A Systematic Review of the Effectiveness of Virtual Reality-Based Interventions on Pain and Range of Joint Movement Associated with Burn Injuries.

BACKGROUND: Burns are mild or severe lesions produced in living tissue, due to the action of different agents. This pathology is considered the third cause of accidental death in the world by the World Health Organization. Among the most disabling sequelae in these patients, pain and range of motion have the greatest impact. A recommended tool to complement the treatment or management of the symptoms associated with burns is virtual reality. OBJECTIVE: The objective of this study was to analyse the effectiveness of virtual-reality therapy for pain relief and the improvement of the range of joint movement in patients who have suffered burns. METHODOLOGY: This study is a systematic review conducted following the PRISMA statements. An electronic literature search was performed in the following databases: PubMed, Cochrane, Dialnet, Scopus and Science Direct. The inclusion criteria were: participants with burns in any part of the body, interventions with virtual reality with or without complementary treatment, studies in both Spanish and English, and outcome measures of pain and range of motion. RESULTS: Finally, 10 studies were included in the review. The sample consisted of one pilot study, three randomized controlled clinical trials, one prospective randomized controlled clinical trial, one control group and treatment group trial, one interventional clinical trial and three comparative studies. The most commonly used assessment tools for pain were the graphic rating scale (GRS) and for range of motion the goniometer. The use of virtual-reality games significantly reduced pain scores during physiotherapy and occupational therapy treatments as well as in nursing care. The range of motion improved significantly during virtual-reality exercises performed during a physiotherapy treatment in 33% of studies included in this review. CONCLUSION: The results of the studies analysed in this systematic review suggest that the use of virtual reality for the management of pain and range of movement limitations associated with burn injuries could control these symptoms and decrease their negative consequences on the person.

Peloids as Thermotherapeutic Agents.

The use of peloids as heat-providing therapeutic systems dates back to antiquity. Such systems consist of a liquid phase and an organic or inorganic solid phase. The latter facilitates the handling, preparation and stability of the solid-liquid system, modifying its organoleptic and phy-sicochemical properties, and improves its efficacy and tolerance. Peloids enable the application of heat to very specific zones and the release of heat at a given rate. The aims of this work are to study 16 reference peloids used in medical spa centers as thermo-therapeutic agents as well as to propose nine raw materials as a solid phase for the preparation of peloids. The physical properties studied are the centesimal composition, the instrumental texture and the thermal parameters. In conclusion, the peloids of the medical spas studied are used as thermotherapeutic agents in the treatment of musculoskeletal disorders, especially in knee osteoarthritis and to a lesser extent in back pain and psoriatic arthropathy. The clinical experience in these centers shows that the main effects of the application of their peloids are the reduction of pain, an increase in the joint's functional capacity and an improvement in the quality of life. As thermotherapeutic agents, all the peloids of the me-dical spas studied and the pastes (raw materials with distilled water) examined showed a heat flow rate of up to four times lower than that shown by the same amount of water. The raw materials studied can be used as solid phases for the preparation of peloids with mineral waters.

Effect of mud-bath therapy on the innate/inflammatory responses in elderly patients with osteoarthritis: a discussion of recent results and a pilot study on the role of the innate function of monocytes.

Recent findings from our laboratory highlight the role of the modulation of the innate immune function and systemic inflammatory response in the effectiveness of balneotherapy in rheumatic diseases, specifically in elderly patients with osteoarthritis. Immune-neuroendocrine and stress mediators are involved in these effects. The 'bioregulatory effect of balneotherapy' has also been recently proposed as a mechanism of effectiveness that consists of a reduction in systemic pro-inflammatory mediators together with the achievement of an optimal innate response through stimulation (or at least lack of impairment) of the innate defences against pathogens (i.e. phagocytosis, microbicide activity) mediated by neutrophils, also generating immunophysiological adaptations through an optimal balance between the pro- and the anti-inflammatory responses in which regulatory T cells seem to have a crucial role. In the present paper, we aim to analyse the main conclusions related to how balneotherapy with the use of peloids (pelotherapy) affects the innate and inflammatory responses, constituting an immunophysiological mechanism underlying the proven clinical benefits of this intervention. We also introduce novel results regarding the innate response (phagocytic process) of monocytes in this therapy, an inflammatory cell that has not yet been studied in this context. Increased chemotaxis together with a decline in oxidative burst, without changes in phagocytosis, could be the main response induced by this modality of balneological intervention.

Innate/inflammatory bioregulation and clinical effectiveness of whole-body hyperthermia (balneotherapy) in elderly patients with osteoarthritis.

OBJECTIVES: Balneotherapy with mud application (mud therapy) is a common hydrothermal intervention for the treatment and rehabilitation of elderly patients with osteoarthritis, leading to anti-inflammatory effects. The main purpose of this investigation was to study a role for regulatory T cells in these anti-inflammatory effects. The second objective was to assess whether the neutrophil-mediated innate response is affected by these anti-inflammatory effects. METHODS: Thirty-six elderly patients with knee osteoarthritis underwent a 10-day cycle of balneotherapy at a spa center. They received daily sessions of whole-body mud therapy at 40-42 °C, using mineral-medicinal water and mud. IL-8 and TGF-ß serum concentrations, percentage of circulating CD4+ CD25+ FOXP3+ and CD8+ CD28- regulatory T cells, and neutrophil phagocytic capacity were evaluated at baseline and at the end of the intervention. Clinical assessments included knee flexion and extension angle, pain, stiffness, physical function and health-related quality of life. RESULTS: All clinical outcomes significantly improved. Circulating concentrations of IL-8 and TGF-ß decreased, which correlated with decreased pain and improved knee flexion, respectively. Percentage of CD4+ regulatory T cells decreased, whereas CD8+ regulatory T cells increased. Neutrophil functional capacity increased. CONCLUSIONS: Balneotherapy with mud application was effective in the management of osteoarthritis symptoms. The anti-inflammatory effect mediated by cytokines contributed to the improvement in pain and joint function; and changes in the circulating percentage of regulatory T cells seem to be involved in the anti-inflammatory effects. Improvement in neutrophil function after mud therapy reflects an optimal bioregulatory effect on the inflammatory and innate responses.

Balneotherapy, Immune System, and Stress Response: A Hormetic Strategy?

Balneotherapy is a clinically effective complementary approach in the treatment of low-grade inflammation- and stress-related pathologies. The biological mechanisms by which immersion in mineral-medicinal water and the application of mud alleviate symptoms of several pathologies are still not completely understood, but it is known that neuroendocrine and immunological responses­including both humoral and cell-mediated immunity­to balneotherapy are involved in these mechanisms of effectiveness; leading to anti-inflammatory, analgesic, antioxidant, chondroprotective, and anabolic effects together with neuroendocrine-immune regulation in different conditions. Hormesis can play a critical role in all these biological effects and mechanisms of effectiveness. The hormetic effects of balneotherapy can be related to non-specific factors such as heat­which induces the heat shock response, and therefore the synthesis and release of heat shock proteins­and also to specific biochemical components such as hydrogen sulfide (H2S) in sulfurous water and radon in radioactive water. Results from several investigations suggest that the beneficial effects of balneotherapy and hydrotherapy are consistent with the concept of hormesis, and thus support a role for hormesis in hydrothermal treatments.

Effects of the application of therapeutic massage in children with cancer: a systematic review.

OBJECTIVE:: to learn about the effects of the use of therapeutic massage in children with cancer. METHOD:: systematic review of controlled clinical trials The search was conducted in November 2014 in the following databases: Pubmed, CSIC, Dialnet, Scopus, Cochrane and PEDro. Inclusion criteria were: clinical trials, published in English or Spanish, analyzing the effects of massage on the different stages and types of childhood cancer (between 1 and 18 years old). RESULTS:: of 1007 articles found, 7 met the inclusion criteria. Their authors use different massage techniques (Swedish massage, effleurage, petrissage, frictions, pressures), obtaining benefits in the symptoms present during the illness (decrease of pain, nausea, stress, anxiety and increase of white blood cells and neutrophils). CONCLUSION:: therapeutic massage improves the symptoms of children with cancer, but there is a need for more research that may support the effects attributed to it. OBJETIVO:: conocer los efectos del uso del masaje terapéutico en niños con cáncer. MÉTODO:: revisión sistemática de ensayos clínicos controlados la búsqueda se llevó a cabo en noviembre de 2014 en las bases de datos científicas: Pubmed, CSIC, Dialnet, Scopus, Cochrane y PEDro. Los criterios de inclusión han sido: ensayos clínicos, publicados en inglés o español, en los que se analizaran los efectos del masaje en las diferentes etapas y tipos de cáncer infantil (entre 1 y 18 años). RESULTADOS:: de 1007 artículos localizados, 7 cumplieron los criterios de inclusión. Sus autores utilizan diferentes técnicas de masaje (masaje sueco, effleurage, petrissage, fricciones, presiones), obteniendo beneficios en los síntomas presentes durante la enfermedad (disminución del dolor, náuseas, estrés, ansiedad y aumento de glóbulos blancos y neutrófilos). CONCLUSIÓN:: el masaje terapéutico mejora los síntomas de los niños con cáncer, que respalden los efectos que se le atribuyen. OBJETIVO:: conhecer os efeitos do uso da massagem terapêutica em crianças com câncer. MÉTODO:: revisão sistemática de ensaios clínicos controlados. A pesquisa foi realizada em novembro de 2014 em bases de dados científicas: Pubmed, CSIC, Dialnet, Scopus, Cochrane and PEDro. Os critérios de inclusão foram: ensaios clínicos, publicados em inglês ou espanhol, analisando os efeitos da massagem nas diferentes fases e tipos de câncer infantil (entre 1 e 18 anos). RESULTADOS:: de 1007 artigos encontrados, 7 preencheram os critérios de inclusão. Os autores utilizam diferentes técnicas de massagem (massagem sueca, effleurage, petrissage, fricções, pressões), obtendo benefícios nos sintomas presentes durante a doença (diminuição da dor, náusea, estresse, ansiedade e aumento de glóbulos brancos e neutrófilos). CONCLUSÃO:: a massagem terapêutica melhora os sintomas das crianças com câncer, mas são necessárias mais pesquisas que apoiem os efeitos atribuídos a ela.

Immune-Neuroendocrine Dysregulation in Patients with Osteoarthritis: A Revision and a Pilot Study.

BACKGROUND: Although osteoarthritis (OA) has predominantly been considered a noninflammatory degenerative arthropathy, there is growing evidence that various inflammatory and immunological processes might contribute to the onset, progression, and burden of the disease. OBJECTIVE: The purpose of the present investigation was to study the systemic inflammatory and stress responses and the innate response mediated by neutrophils in OA patients. METHOD: A group of patients diagnosed with primary OA according to the American College of Rheumatology criteria and a control group of age-matched healthy volunteers were enrolled in the study. Serum inflammatory cytokine levels (IL-1ß, TNF-α, IL-8, IL-6, IL-10, and TGF-ß) were evaluated using the Bio-Plex Luminex system. Circulating neuroendocrine-stress biomarkers, such as cortisol and extracellular 72 kDa heat shock protein (eHsp72), were measured by ELISA. The phagocytic and microbicide capacities of circulating neutrophils were evaluated by flow cytometry. All parameters were determined in all volunteers. RESULTS: The OA patients showed an inflammatory state accompanied by an altered stress response. This was manifested in high circulating levels of the inflammatory cytokines IL-1ß, TNF-α, IL-8, IL-6, and TGF-ß and the stress protein eHsp72. There were also decreased systemic levels of cortisol, and a reduction in neutrophil phagocytic and microbicidal capacities. CONCLUSION: An immune-neuroendocrine dysregulation affecting both systemic inflammatory and stress mediators and the function of innate immune cells underlies OA. This reflects an altered feedback between the innate/inflammatory and stress responses in this pathology.

Effects of the application of therapeutic massage in children with cancer: a systematic review / Efectos de la aplicación del masaje terapéutico en niños con cáncer: una revisión sistemática / Efeitos da aplicação de massagem terapêutica em crianças com câncer: uma revisão sistemática

ABSTRACT Objective: to learn about the effects of the use of therapeutic massage in children with cancer. Method: systematic review of controlled clinical trials The search was conducted in November 2014 in the following databases: Pubmed, CSIC, Dialnet, Scopus, Cochrane and PEDro. Inclusion criteria were: clinical trials, published in English or Spanish, analyzing the effects of massage on the different stages and types of childhood cancer (between 1 and 18 years old). Results: of 1007 articles found, 7 met the inclusion criteria. Their authors use different massage techniques (Swedish massage, effleurage, petrissage, frictions, pressures), obtaining benefits in the symptoms present during the illness (decrease of pain, nausea, stress, anxiety and increase of white blood cells and neutrophils). Conclusion: therapeutic massage improves the symptoms of children with cancer, but there is a need for more research that may support the effects attributed to it.

RESUMEN Objetivo: conocer los efectos del uso del masaje terapéutico en niños con cáncer. Método: revisión sistemática de ensayos clínicos controlados la búsqueda se llevó a cabo en noviembre de 2014 en las bases de datos científicas: Pubmed, CSIC, Dialnet, Scopus, Cochrane y PEDro. Los criterios de inclusión han sido: ensayos clínicos, publicados en inglés o español, en los que se analizaran los efectos del masaje en las diferentes etapas y tipos de cáncer infantil (entre 1 y 18 años). Resultados: de 1007 artículos localizados, 7 cumplieron los criterios de inclusión. Sus autores utilizan diferentes técnicas de masaje (masaje sueco, effleurage, petrissage, fricciones, presiones), obteniendo beneficios en los síntomas presentes durante la enfermedad (disminución del dolor, náuseas, estrés, ansiedad y aumento de glóbulos blancos y neutrófilos). Conclusión: el masaje terapéutico mejora los síntomas de los niños con cáncer, que respalden los efectos que se le atribuyen.

RESUMO Objetivo: conhecer os efeitos do uso da massagem terapêutica em crianças com câncer. Método: revisão sistemática de ensaios clínicos controlados. A pesquisa foi realizada em novembro de 2014 em bases de dados científicas: Pubmed, CSIC, Dialnet, Scopus, Cochrane and PEDro. Os critérios de inclusão foram: ensaios clínicos, publicados em inglês ou espanhol, analisando os efeitos da massagem nas diferentes fases e tipos de câncer infantil (entre 1 e 18 anos). Resultados: de 1007 artigos encontrados, 7 preencheram os critérios de inclusão. Os autores utilizam diferentes técnicas de massagem (massagem sueca, effleurage, petrissage, fricções, pressões), obtendo benefícios nos sintomas presentes durante a doença (diminuição da dor, náusea, estresse, ansiedade e aumento de glóbulos brancos e neutrófilos). Conclusão: a massagem terapêutica melhora os sintomas das crianças com câncer, mas são necessárias mais pesquisas que apoiem os efeitos atribuídos a ela.

Efectos de la terapia con peloides sobre el dolor percibido y la calidad de vida relacionada con la salud en pacientes con artrosis de rodilla / Effects of mud therapy on perceived pain and quality of life related to health inpatients with knee osteoarthritis

Objetivo. Analizar los efectos de la terapia con peloides sobre el dolor percibido, la calidad de vida relacionada con la salud (CVRS) y el consumo de medicamentos en sujetos diagnosticados de artrosis de rodilla. Material y métodos. Ensayo clínico prospectivo y controlado. La muestra (n=147) fue dividida en un grupo experimental (GE) de 61 sujetos (69,13±5,60 años), que recibió 11 sesiones consecutivas de peloides en la rodilla afectada según el procedimiento terapéutico descrito, y un grupo control (GC) de 60 sujetos (73,08±8,90 años), que continuó con su tratamiento farmacológico rutinario. La muestra fue valorada antes y después de la intervención mediante el cuestionario SF-36, la escala visual analógica y la evolución en el consumo de medicamentos, estableciendo el nivel de significación para p≤0,05. Resultados. Tras finalizar la intervención, existieron diferencias estadísticamente significativas (p<0,05) en todas las variables analizadas entre el GE y GC, reduciéndose el consumo de medicamentos en el GE frente a la ausencia de cambios en el GC. Las dimensiones salud general, dolor corporal y el dolor percibido son las que muestran mayores cambios entre ambos grupos. Conclusiones. La peloterapia en pacientes diagnosticados de artrosis de rodilla obtiene efectos inmediatos sobre el dolor percibido y la CVRS, reduciendo el consumo de medicamentos específicos. Son necesarios estudios evalúen desde la evidencia científica los efectos de dicha intervención(AU)

Objective: To analyze the effects of mud therapy on perceived pain, Health Related Quality of Life (HRQL) and drug use in patients diagnosed with knee osteoarthritis. Material and methods: A prospective, controlled clinical trial. The sample (n = 147) was divided into an experimental group (EG) of 61 subjects (69.13 ± 5,60 years) who received 11 consecutive sessions of peloids in the knee/s affected by the process described and a control group (CG) of 60 subjects (73.08 ± 8,90 years) who continued routine drug treatment. The sample was assessed before and after intervention using the SF-36, Visual Analogue Scale and changes in drug use, setting a significance level of P<=.05. Results: After the intervention, there were statistically significant differences (P<.05) in all parameters analyzed between EG and CG, reduced drug use in the EG versus no change in the CG. The general health, bodily pain and perceived pain are those that show major changes between the two groups. Conclusions: Mud therapy in patients diagnosed with knee osteoarthritis attains immediate effects on perceived pain and HRQOL, reducing the consumption of specific drugs. Studies are needed to evaluate the scientific evidence from the effects of such intervention(AU)

Effects of mud therapy on perceived pain and quality of life related to health in patients with knee osteoarthritis.

OBJECTIVE: To analyze the effects of mud therapy on perceived pain, Health Related Quality of Life (HRQL) and drug use in patients diagnosed with knee osteoarthritis. MATERIAL AND METHODS: A prospective, controlled clinical trial. The sample (n=147) was divided into an experimental group (EG) of 61 subjects (69.13 ± 5,60 years) who received 11 consecutive sessions of peloids in the knee/s affected by the process described and a control group (CG) of 60 subjects (73.08 ± 8,90 years) who continued routine drug treatment. The sample was assessed before and after intervention using the SF-36, Visual Analogue Scale and changes in drug use, setting a significance level of P ≤ .05. RESULTS: After the intervention, there were statistically significant differences (P<.05) in all parameters analyzed between EG and CG, reduced drug use in the EG versus no change in the CG. The general health, bodily pain and perceived pain are those that show major changes between the two groups. CONCLUSIONS: Mud therapy in patients diagnosed with knee osteoarthritis attains immediate effects on perceived pain and HRQOL, reducing the consumption of specific drugs. Studies are needed to evaluate the scientific evidence from the effects of such intervention.

Clinical effectiveness of mud pack therapy in knee osteoarthritis.

OBJECTIVE: The main objective of this study was to systematically review all the scientific studies that analyse the effectiveness of mud pack therapy on patients diagnosed with knee OA. METHODS: One hundred and fifteen publications were identified through an electronic and manual search and 20 of those studies were chosen based on the inclusion criteria: randomized clinical trials, systematic reviews or meta-analyses whose objective was to analyse the effect of mud pack therapy on perceived pain, function and quality of life, with a sample size of ≥20 subjects, published since 2000 and showing conclusive results. RESULTS: In the studies that met the inclusion criteria, 12 analyse functionality, 17 perceived pain, 5 quality of life and all showed a significant improvement in the three analysed variables. The methodological quality of the studies had a moderate risk of bias. CONCLUSION: Mud pack therapy is considered an alternative and effective therapy in the clinical management of knee OA. Studies with better methodology are needed to prove its scope.