Mind-body exercises for osteoarthritis: an overview of systematic reviews including 32 meta-analyses.

PURPOSE: To develop an overview of systematic reviews (SRs) to summarize the current evidence on the effectiveness of mind-body exercises, specifically qigong, tai chi, and yoga, on osteoarthritis-related symptoms. METHODS: CINAHL, Embase, PsycINFO, PubMed, SPORTDiscus, and the Cochrane Library were searched from inception up to 20 June 2022. Pain, physical function, psychological symptoms, and quality of life were analyzed. AMSTAR 2 was used to assess the methodological quality of SRs. The primary study overlap among SRs was calculated. RESULTS: A total of 13 SRs were selected, including 32 meta-analyses of interest that comprised 33 distinct primary studies. Overall, qigong, tai chi, and yoga-based interventions may improve osteoarthritis-related symptoms, mainly physical function. However, no SRs were judged to have high methodological quality. Only three SRs judged certainty of evidence using a gold standard for it. The primary study overlap was very high for SRs covering tai chi or yoga trials. CONCLUSIONS: There was a positive tendency in favor of these mind-body exercises for improving pain, arthritis self-efficacy, and mainly, physical function. Unfortunately, no clinical recommendations can be made due to the high number of methodological concerns that were described above. New high-quality SRs covering this topic are needed.IMPLICATIONS FOR REHABILITATIONIt appears that qigong, tai chi, and yoga may improve physical function in osteoarthritis.In addition, tai chi may improve arthritis self-efficacy in knee osteoarthritis.As most of the included systematic reviews (SRs) had low quality, no firm recommendations can be made.Most of the included SRs did not evaluate the certainty in the evidence.

Meaningful and experiential learning in a fascial approach in practice education in the degree of physiotherapy: A pilot study at a Spanish University.

BACKGROUND AND INTRODUCTION: A pilot experience of teaching innovation was developed in the masotherapy practice classes of the University of Seville's degree of physiotherapy using an active learning approach. OBJECTIVE: Significant experiential learning-specific teaching strategies were implemented to address learning style diversity and promote dynamic participation, active listening, and the creation of clinical simulation learning environments. METHODS: The strategies implemented included establishing an affective climate in the classroom that would encourage interaction among participants, facilitating the flow of information and the teaching-learning process, considering students' previous ideas, elaborating upon content maps and key questions to guide the teaching-learning process, establishing discussions favoring student brainstorming, using illustrations and videos ("visual thinking"), implementing experimental demonstrations and simulated clinical scenarios, and collaborative activities mediated by information and communication technology. RESULTS: The evaluation, which was developed using a questionnaire (pretest-posttest) that allowed the development of learning ladders and considered the complexity of the generated knowledge, revealed significant advances in student learning. CONCLUSION: The implementation of significant experiential learning-specific teaching strategies is useful for achieving the learning objectives of this subject. Further research is needed to conclude firmly in this regard.

The Effects of Mind-Body Exercises on Chronic Spinal Pain Outcomes: A Synthesis Based on 72 Meta-Analyses.

An umbrella review of systematic reviews with a meta-analysis was developed to summarize the evidence on the effectiveness of qigong, tai chi, and yoga in chronic spinal pain outcomes. The CINAHL, Cochrane Library, Embase, PsycINFO, PubMed and SPORTDiscus databases were searched. Pain, psychological factors, and quality of life (QOL) were the outcomes of interest. The methodological quality of the reviews was evaluated using the AMSTAR-2 tool. The overlap was calculated using the corrected covered area. A total of 72 meta-analyses drawn from 20 systematic reviews were included and often were rated at a critically low quality. The effects of qigong on chronic low back and neck pain (CLBP and CNP, respectively) were inconsistent, although it improved the physical component of QOL after 12 weeks for CNP. Tai chi was superior to the controls in reducing CLBP; no reviews of interest were found on CNP. Yoga was superior to multiple controls in reducing CLBP, but no relevant effects on depression or QOL were found. QOL, anxiety, depression, and general mood improved with yoga for CNP. Inconsistencies arose related to yoga and CNP. Our findings mainly supported the potential effects of yoga and tai chi on pain-related outcomes, psychological factors, and QOL in populations with CLBP and NP. Clinical and methodological considerations were discussed.

Effects of Training on Cardiorespiratory Fitness in Triathletes: A Systematic Review and Meta-Analysis.

Triathlon is an aerobic sport, which is commonly measured by maximal aerobic consumption (VO2max). OBJECTIVE: to analyze the changes produced in cardiorespiratory and physiological measurements during practice, which determine triathletes' performance level. A systematic review and a meta-analysis based on PRISMA protocol and registered in PROSPERO (CRD42020189076) was conducted. The research was performed using PubMed, SPORTDiscus, Embase, Dialnet, Web of Science (WOS) and MEDLINE databases during February and March 2020. Studies that measured cardiorespiratory variables in triathletes published in the last 10 years were included. RESULTS: 713 articles were identified, with 25 studies selected for the systematic review and five articles for the meta-analysis. These articles concluded that the main cardiorespiratory variables that determine triathletes' performance were modified depending on the triathlon segment performed and the athletes' sex and age. The meta-analysis showed no conclusive results related to the effects of changes in VO2max in triathletes' performance [SMD = -0.21; 95%CI: (-0.84 to 0.43)]. CONCLUSIONS: cardiorespiratory fitness, in terms of VO2max and ventilatory thresholds, is the strongest predictor of performance in triathlon. This response may be affected depending on the triathlon segment performed and the athlete's age or sex, leading to both physiological and biomechanical alterations that affect competition performance.

Inclusive Design in the Field of Education from the Paradigm of Early Intervention.

Inclusive education and early intervention go hand in hand in the early educational stages to reach the maximum potential of the student body. The aim of this study was to analyze the inclusive profile of an educational center and assess the effectiveness of an inclusive task (designed for this study) in a group of students of early childhood education. This analytical, prospective, descriptive and longitudinal study was conducted from both qualitative and quantitative approaches. From the qualitative approach, an interview was carried out with early childhood education teachers. A total of nine participants were interviewed. Their mean age was 42.25 ± 9.30 years, with a mean experience of 14.25 ± 9.25 years. The quantitative part of the study was carried out with 97 students of early childhood education. After delivering a learning workshop about awareness of functional diversity, three variables were analyzed: story memory, demonstrated emotion, and game memory. The qualitative study indicates that it is necessary to develop coping strategies, such as including special education tasks in the classroom, prior to specific staff training and programming in specific aspects of awareness. Moreover, it is shown that the perception of treatment among peers is already present at this educational stage. The quantitative study reveals that the task was exciting and motivating for the students, which promotes learning and awareness.

Effectiveness of Topical Anesthetics in Pain Management for Dermal Injuries: A Systematic Review.

The treatment of dermal injuries is associated with pain in both adult and pediatric populations. We reviewed traditional treatments for controlling the pain of these lesions, such as infiltrated local anesthetics and topical local anesthetics. The objective of this review was to elucidate the efficacy of topical anesthetics in reducing the pain of dermal injuries, as well as the efficacy of topical anesthetics versus other anesthetics, or versus a placebo. METHODOLOGY: a systematic review was carried out by searching Medline (PubMED), Scopus, Cinahl, Cochrane, Lilacs, and ENFISPO for randomized clinical trials on the control of pain in dermal lesions through the use of topical anesthetics, versus a placebo or versus another anesthetic. RESULTS: twelve randomized clinical trials with a total of 952 patients were included. Seven studies analyzed the efficacy of topical anesthetics compared to a placebo, and six of them observed statistically significant differences in favor of the experimental group. Five studies analyzed the efficacy of topical anesthetics compared to other anesthetics or sedatives; three of them observed statistically significant differences in favor of the experimental group, and two found no difference between the anesthetics analyzed. CONCLUSION: topical anesthesia is a useful method for pain control, is safe compared to other traditional methods, and offers a satisfactory form of pain relief in relation to infiltration anesthesia and compared to placebo.

Relationship between perimetric increase and fluoroscopic pattern type in secondary upper limb lymphedema observed by Indocyanine green lymphography.

To ascertain the relationship between the perimetric differences obtained between the limbs and the type of fluoroscopic pattern observed by Indocyanine green (ICG) lymphography in patients with upper limb lymphedema.A correlational descriptive study was carried out in 19 patients with upper limb lymphedema secondary to breast cancer. The perimetric increase was recorded in 11 anatomical regions after ICG injection, fluoroscopic patterns were identified using an infrared camera. The ICG patterns were categorized into worse (stardust, diffuse) or better (linear, splash) patterns.The pattern coincidence between the anterior and posterior regions of the edematous extremities was 45%. At the wrist level, a difference of 2 cm was associated with the presence of a worse fluoroscopic pattern, whereas perimeter differences of 4.25 cm in the elbow and 2.25 cm in the arm (12 cm from the epicondyle) were associated with the presence of a better fluoroscopic pattern.The perimetric differences observed between the healthy and affected upper limbs in 4 specific anatomical areas allowed us to predict the type of fluoroscopic pattern. ICG lymphography has facilitated the study of the posterior regions of edema, which are difficult to visualize using other imaging techniques.

The Efficacy of Therapeutic Respiratory Muscle Training Interventions in People with Bronchiectasis: A Systematic Review and Meta-Analysis.

Background: Respiratory muscle dysfunction is an important health problem with high morbidity and mortality and associated costs in patients with bronchiectasis (BC). The aim of this study was to analyse the effects of therapeutic respiratory muscle training (RMT) interventions on improving sputum clearance, ventilator function, muscle strength and functional capacity in BC. Methods: Systematic review and meta-analysis were conducted following PRISMA guidelines. Two independent investigators searched using several electronic databases. The methodological quality of nine studies was assessed using the PEDro scale. Study selection/eligibility criteria: The following were included: randomised controlled trials, randomised crossover trials and pilot studies of patients with BC that used the intervention as RMT (inspiratory/expiratory) and evaluations of respiratory muscle strength (maximal expiratory pressure/maximal inspiratory pressure). This systematic review was registered in PROSPERO (CRD42017075101). Nine studies were included, five of which obtained an A recommendation grade, three with B, and one with C. Study quality was poor to good (mean PEDro Score of 6.375 out of 10). Studies had small sample sizes (8-98). Results show improvements on PImax in favour of therapeutic respiratory muscle training intervention (MD = 6.08; 95% CI = 1.38, 10.77; p < 0.01; I2 = 92%). However, high heterogeneity was identified on meta-analysis.

Changes in Indocyanine Green Lymphography Patterns after Physical Treatment in Secondary Upper Limb Lymphedema.

Indocyanine green (ICG) lymphography is used to evaluate the lymphatic function before and after pneumatic compression or post-manual lymphatic drainage. The aim of this study was to ascertain the changes in the fluoroscopic pattern produced by the provision of complex physical therapy. This prospective analytic (pretest-posttest) study was conducted in 19 patients with upper lymphedema secondary to breast cancer. Nine patients were excluded due to ICG found after 3 weeks. The ICG patterns were analyzed under basal conditions and after three weeks of treatment. After the treatment, 45% of the patients presented tracer remains in the affected limb, and this finding was significantly related to time of the lymphedema development. In one subject, the patterns remain unchanged or cannot be defined. Three of the ten patients observed present the worsening of at least 1 of the patterns and in the rest of the subjects, six cases, the improvement of the patterns is observed. In 60% of the cases, the most severe pattern reversed towards slight (splash) cases, and moderate cases reversed towards a slight case in 70% of cases. Therefore, after treatment with complex physical therapy, the pathological patterns observed in the pretest, which evolved positively, reverted their severity toward milder disease patterns or towards normality.

Visualization of Accessory Lymphatic Pathways, before and after Manual Drainage, in Secondary Upper Limb Lymphedema Using Indocyanine Green Lymphography.

Manual Lymphatic Drainage (MLD) appears to stimulate lymphatic contraction, aid in the development of secondary derivation pathways, and stimulate the appearance of collateral pathways that could function as the main drainage routes of the limb in case of lymphedema. Through stretching, call up maneuvers are used to stimulate lymphangion reflex contraction and, therefore, lymphatic function. The aim was to describe the presence of areas and pathways of collateral lymphatic drainage under basal conditions and to determine, using Indocyanine Green (ICG) lymphography, whether an increase in these pathways occurs after 30 min of manual lymphatic stimulation with only call up maneuvers according to the Leduc Method®®. In this prospective analytical study (pretest-posttest), the frequency of presentation of areas and collateral lymphatic pathways was analyzed in 19 patients with secondary lymphedema of the upper limb after breast cancer using an infrared camera. Analyses were completed at three time points: after ICG injection, at baseline (pretest), and after the application of MLD (post-test). The Leduc Method maneuvers were applied to the supraclavicular and axillary nodes, chest, back, Mascagni, and Caplan pathways. The areas visualized in the pretest continued to be visible in the posttest. Additional pathways and fluorescent areas were observed after the maneuvers. The McNemar test showed statistical significance (p = 0.008), the odds ratio was infinite, and the Cohen's g value was equal to 0.5. Manual stimulation by call up maneuvers increased the observation frequency of areas and collateral lymphatic pathways. Therefore, ICG lymphography appears to be a useful tool for bringing out the routes of collateral bypass in secondary lymphoedema after cancer treatment.

Therapeutic Exercise in the Treatment of Primary Dysmenorrhea: A Systematic Review and Meta-Analysis.

BACKGROUND: Dysmenorrhea is a health problem with a high impact on health and society. Some drugs have been shown to be effective at treating dysmenorrhea. Therapeutic exercise is another option for reducing the symptomatology of this health problem, with a low cost and the absence of side effects. PURPOSE: The purposes of this review were to study the efficacy of physical exercise for pain intensity in primary dysmenorrhea and to assess its effectiveness in decreasing the duration of pain and improving quality of life. DATA SOURCES: Searches were conducted between February 2017 and May 2017 in the databases Web of Science, Physiotherapy Evidence Database (PEDro), PubMed, Scopus, CINAHL, and Dialnet, using the terms dysmenorrhea, exercise therapy, exercise movement technique, exercise, physical therapy, physical therapy speciality, treatment, primary dysmenorrhea, prevention, etiology, epidemiology, and pain. STUDY SELECTION: We included randomized controlled trial studies conducted on women who were 16 to 25 years old and had primary dysmenorrhea, studies that included exercise as a type of therapy, studies that assessed the intensity and duration of pain and quality of life, and studies published in English or Spanish. Studies that included women with irregular cycles, women diagnosed with a gynecological disease, women who had had surgery, women with serious diseases, or women who used intracavitary or oral contraceptives were excluded. We started with 455 studies; 16 were included in the systematic review, and 11 were included in the 3 meta-analyses that were carried out. DATA EXTRACTION: Two authors selected the studies and extracted their characteristics (participants, intervention, comparators, and outcomes) and results. The evaluation of the methodological quality of the studies was carried out by PEDro scale. DATA SYNTHESIS: There was moderate evidence that therapeutic exercise can be considered a useful tool in the treatment of primary dysmenorrhea in terms of a reduction in pain intensity. Regarding the duration of pain and quality of life, there was low evidence and very low evidence, respectively. In the 3 meta-analyses, the results were significantly positive in favor of exercise for decreases in both the intensity and the duration of pain. LIMITATIONS: Limitations of this study include the great heterogeneity of the interventions applied in the studies in terms of type of exercise, in combination or alone, and dosage. This review includes a small number of studies with risk of bias, so the present findings must be interpreted with caution. CONCLUSIONS: Therapeutic exercise reduces pain intensity in patients with primary dysmenorrhea.

[Effectiveness of an individualised physiotherapy program versus group therapy on neck pain and disability in patients with acute and subacute mechanical neck pain]. / Eficacia ante el dolor y la discapacidad cervical de un programa de fisioterapia individual frente a uno colectivo en la cervicalgia mecánica aguda y subaguda.

OBJECTIVE: To compare the efficacy in reducing neck pain and disability in an individualised physiotherapy treatment with group treatment in acute and subacute mechanical neck pain. DESIGN: Randomised clinical trial. LOCATION: Health Area of University Hospital Virgen del Rocío, Seville, Spain. PARTICIPANTS: A total of 90 patients diagnosed with mechanical neck pain of up to one month onset, distributed randomly into two groups: (i)individualised treatment; (ii)group treatment. INTERVENTION: The treatment consisted of 15 sessions of about 60minutes for both groups. Individual treatment consisted of 15minutes of infrared heat therapy, 17minutes of massage, and analytical passive stretching of the trapezius muscles and angle of the scapula. The group treatment consisted of a program of active mobilisation, isometric contractions, self-stretching, and postural recommendations. MAIN MEASURES: Pain was measured at the beginning and end of treatment pain using a Visual Analogue Scale (VAS) and an algometer applied on the trapezius muscles and angle of the scapula, and neck disability using the Neck Disability Index. RESULTS: Both treatments were statistically significant (P<.001) in improving all variables. Statistically significant differences (P<.001) were found for all of them in favour of individualised treatment compared to group treatment. CONCLUSIONS: Patients with acute or subacute mechanical neck pain experienced an improvement in pain and neck disability after receiving either of the physiotherapy treatments used in our study, with the individual treatment being more effective than collective.

Systematic Review of Inspiratory Muscle Training After Cerebrovascular Accident.

This systematic review examines levels of evidence and recommendation grades of various therapeutic interventions of inspiratory muscle training in people who have had a stroke. Benefits from different levels of force and resistance in respiratory muscles are shown in this population. This review was conducted following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) directives and was completed in November 2014. The search limits were studies published in English between 2004 and 2014. Relevant studies were searched for in MEDLINE, PEDro, OAIster, Scopus, PsycINFO, Web of Knowledge, CINAHL, SPORTDiscus, DOAJ, Cochrane, Embase, Academic Search Complete, Fuente Académica, and MedicLatina. Initially, 20 articles were identified. After analyzing all primary documents, 14 studies were excluded. Only 6 studies were relevant to this review. Three different types of interventions were found (maximum inspiratory training, controlled training, and nonintervention) in 3 different groups. One specific study compared 3 inspiratory muscle training groups with a group of breathing exercises (diaphragmatic exercises with pursed lips) and a control group. Future long-term studies with larger sample sizes are needed. It is necessary to apply respiratory muscle training as a service of the national health system and to consider its inclusion in the conventional neurological program.

The efficacy of capacitive radio-frequency diathermy in reducing buttock and posterior thigh cellulite measured through the cellulite severity scale.

BACKGROUND: Cellulite, despite its high prevalence in women, has been subjected to very little research, while the majority has been carried out using unvalidated evaluation tools. OBJECTIVES: To determine the efficacy of capacitive radio-frequency diathermy (CRFD) in reducing buttock and posterior thigh cellulite and to verify its relationship with the reduction of body weight. METHODS: Design: Experimental clinical study consists of two parallel groups. SAMPLE: Totally 54 lower limbs of 27 women (26.41 ± 6.16 years) were considered with each patient's two limbs being assigned one to each group via simple random distribution. First group received local application of CRFD (30 min) and the second received the same treatment followed by a supplementary whole-segment application of CRFD (20 min). Each limb received 20 sessions, twice a week. VARIABLES: Cellulite Severity Scale dimensions score, weight and Body Mass Index (BMI) were taken for the evaluation of the study. RESULTS: A significance of p less than 0.01 was observed for all the variables in both groups, thereby demonstrating the effectiveness of both the treatments; no significant differences were observed between groups (p > 0.05). CONCLUSIONS: Monopolar static application of CRFD is effective in reducing buttock and posterior thigh cellulite. It appears that there is not necessarily any relationship between weight loss, decreased BMI and reduction in cellulite.

Spanish version of the broome pelvic muscle self-efficacy scale: validity and reliability.

BACKGROUND: Self-efficacy appears to be an important predictor of functional recovery for women with urinary incontinence, but no specific Spanish-language questionnaires for measuring pelvic-floor exercise self-efficacy exist. OBJECTIVE: The aim of this study was to design a valid and reliable Spanish version of the Broome Pelvic Muscle Self-Efficacy Scale to measure self-efficacy, as perceived by women with urinary incontinence, in performing pelvic-floor exercises. DESIGN: This was an observational validation study. METHODS: Translation-back translation was used to design the survey, and then the survey was validated with a sample of 119 women who were incontinent and had undergone a pelvic-floor exercise training program. The reliability and construct validity of the questionnaire were assessed. Descriptive statistics were used to score the questionnaire. Internal consistency was evaluated with the Cronbach alpha coefficient and the Pearson correlation coefficient. Exploratory factor analysis with both the principal components extraction method and the varimax rotation method was used to assess construct validity. RESULTS: The reliability coefficient (Cronbach alpha=.91) and the correlations among items were high. The factor analysis revealed that 6 main factors accounted for 75.8% of the variance. LIMITATIONS: Conclusions regarding the validity of the questionnaire should be drawn with caution because of the inability to assess criterion-related validity. CONCLUSIONS: The Spanish version of the Broome questionnaire for self-efficacy appears to be useful as a measuring tool for a psychometrically accurate, clinically relevant estimation of women's self-efficacy in performing pelvic-floor exercises.