The associations between menopausal symptoms and sleep quality in Spanish postmenopausal women.

Objectives: Around the menopause, sleep disturbances frequently occur or worsen and are associated with decreased health quality and physical and psychological problems. The aim of this study was to analyze sleep quality and its association with the impact of menopausal symptoms in Spanish postmenopausal women. Methods: A total of 278 postmenopausal women (age 60.95 ± 8.01 years) participated in this cross-sectional study. The Medical Outcomes Study Sleep Scale (MOS-SS) and the Menopause Rating Scale (MRS) were used to analyze sleep quality and severity of menopausal symptoms, respectively. Anxiety and depression were measured using the Hospital Anxiety and Depression Scale. Results: The linear regression showed that a greater impact of menopausal symptoms (MRS total score) was associated with worse scores regarding sleep adequacy (p < 0.001, R2 = 0.056), snoring (p = 0.020, R2 = 0.036), awaken short of breath (p < 0.001, R2 = 0.089), and quantity of sleep (p < 0.001, R2 = 0.075) domains. Anxiety (p < 0.001) and worse somatic symptoms (p = 0.001) were related to greater sleep disturbances (R2 = 0.164). We also found relationships of heightened psychological symptoms (p < 0.001) and low physical activity level (p = 0.003) with increased daytime somnolence (R2 = 0.064). Finally, higher MRS total score and anxiety levels were associated with worse sleep quality assessed by MOS-SS Sleep Problems Index I (R2 = 0.179, p < 0.001 and p = 0.001, respectively) and Sleep Problems Index II (R2 = 0.146, p < 0.001 and p = 0.011, respectively). Conclusions: Anxiety and severity of menopausal symptoms were associated with poorer sleep quality. Furthermore, low physical activity level and worse psychological symptoms in menopause were predictors for increased somnolence. Therefore, screening for these factors in postmenopausal women is important, since they may be susceptible for intervention.

Effects of 6 Weeks of Balance Training on Chronic Ankle Instability in Athletes: A Randomized Controlled Trial.

The objective of the present study was to determine the effectiveness of a 6-week balance training program on patients with Chronic Ankle Instability (CAI) in relation to the results obtained in Dynamic Balance, subjective feeling of instability and pain using a single-blind randomized controlled trial. 70 athletes were randomly assigned to control or intervention group. The control group performed their usual training, and the intervention group was administered the same usual activity in addition to a balance program. The paired t-test was performed to evaluate the change scores in each group. The t-test for independent samples was performed to evaluate between-group differences in change scores. Significance level was assigned for p-values less than 0.05 for all analyses. There were significant differences between groups in change scores in CAIT and all of the SEBTs reach distances (p<0.001) but not in Pain (p=0.586). The effect sizes were larger for the outcomes measures that showed significant differences. In the within-group change, the experimental groups showed larger effect sizes in CAIT, SEBT posteromedial and SEBT posterolateral, and moderate effect sizes in SEBT anterior. Exercise therapy training based on multi-station balance tasks led to significant improvements in dynamic balance and self-reported sensation of instability in patients with CAI.

Effects of an anaerobic lactic training session on the postural stability of athletes.

AIM: The aim of this study was to analyze the short-term effects of a lactate-accumulation training session on postural stability. METHODS: Fifteen athletes performed two trainings sessions (warm-up and lactic-training session). Before training (Pre), immediately after (Post(0min)), thirty minutes later (Post(30min)) and after 24 hours (Post(24h)), athletes were subject to a bipodal and a monopodal stabilometries and a lactate blood analysis to ensure a high stress level. RESULTS: Variance analysis (α=0.05) showed that, in lactic training, athletes experienced an increase of length and velocity in post(0min), a decrease at post(30min) and a new decrease at post(24h), which was lower than basal values. In monopodal stability, left-leg support showed a decrease at post(0min) in anteroposterior plane of athletes after lactic training. Also, in both monopodal supports, athletes displayed higher values of length and velocity in post(0min) after lactic training, with a progressive decrease which was significant at Post(24h), when they reached baseline. CONCLUSION: Right after anaerobic lactic training, center-of-pressure dispersion variables in bipodal stabilometry are worsened. Thirty minutes later, stabilometric variables are still deteriorated. At 24 hours, stabilometry is better than baseline. In monopodal support, dispersion values are worsened after lactic training and anteroposterior stability is impaired in left monopodal support, although the deterioration is less evident as time passes.

Tissue damage markers after a spinal manipulation in healthy subjects: a preliminary report of a randomized controlled trial.

Spinal manipulation (SM) is a manual therapy technique frequently applied to treat musculoskeletal disorders because of its analgesic effects. It is defined by a manual procedure involving a directed impulse to move a joint past its physiologic range of movement (ROM). In this sense, to exceed the physiologic ROM of a joint could trigger tissue damage, which might represent an adverse effect associated with spinal manipulation. The present work tries to explore the presence of tissue damage associated with SM through the damage markers analysis. Thirty healthy subjects recruited at the University of Jaén were submitted to a placebo SM (control group; n = 10), a single lower cervical manipulation (cervical group; n = 10), and a thoracic manipulation (n = 10). Before the intervention, blood samples were extracted and centrifuged to obtain plasma and serum. The procedure was repeated right after the intervention and two hours after the intervention. Tissue damage markers creatine phosphokinase (CPK), lactate dehydrogenase (LDH), C-reactive protein (CRP), troponin-I, myoglobin, neuron-specific enolase (NSE), and aldolase were determined in samples. Statistical analysis was performed through a 3 × 3 mixed-model ANOVA. Neither cervical manipulation nor thoracic manipulation did produce significant changes in the CPK, LDH, CRP, troponin-I, myoglobin, NSE, or aldolase blood levels. Our data suggest that the mechanical strain produced by SM seems to be innocuous to the joints and surrounding tissues in healthy subjects.

Predictive value of stabilometry and fear of falling on falls in postmenopausal women.

OBJECTIVES: Falls are one of the leading causes of fractures and impaired quality of life in the elderly, and they are related to balance deficit and to fear of falls. The purpose of our study is to evaluate predictors of falls in the 50-65-year-old postmenopausal population. METHODS: A prospective cohort study was conducted on 96 postmenopausal women. Fear of falling and postural stability were assessed by using the FES-I (Falls Efficacy Scale-International) and a force platform, respectively. Fall frequency was determined in the 12-month follow-up study period. Multivariate logistic regression was used to identify predictive factors of falls. RESULTS: Fear of falls, the FES-I scale and four stabilometric parameters, specifically under eyes-closed condition, were significantly higher in the group of fallers. The root mean square amplitude in the medial-lateral direction with eyes closed (RMSXec) (odds ratio 5.1, 95% confidence interval (CI) 1.6-15.5, p = 0.004) and FES-I (odds ratio 3.4, 95% CI 1.1-10.5, p = 0.026) were the best independent predictive factors of the risk of falling. CONCLUSIONS: RMSXec > 0.133 was the best predictive factor for falls in our group of 50-65-year-old postmenopausal women studied, and a FES-I score > 20 could predict falls in this population.

Outpatients' perceptions of their experiences in musculoskeletal rehabilitation care.

BACKGROUND: While patients' satisfaction with rehabilitation care is often measured, the knowledge of their experiences during delivery of care and of which characteristics may lead them to experience problems remains largely undocumented. AIM: To assess the quality of patients' experiences receiving post-acute care for musculoskeletal disorders in outpatient rehabilitation settings. To describe the extent to which variations in reported quality of patients' experiences were related to their characteristics. DESIGN: A cross sectional, self-reported survey. SETTING: 3 outpatient rehabilitation units. POPULATION: Four hundred sixty-five outpatients. Mean age 39.4 (SD=11.9). METHODS: A problem score (from 0 to 100%) of self-reported experiences was calculated on 7 specific aspects of care (belonging to organizational environment and professionals' attitudes and behaviors) and compared among participants' subgroups. RESULTS: Mean scores of the organizational environment area showed higher amount of problems (43.3%) than the professionals' attitudes and behaviours area (34.7%). Two multivariate linear regression models (with adjusted R(2) 9.3% and 4.9%) indicated that older patients and those with high global rating change were less likely to experience problems in the two areas. CONCLUSION: Problems on aspects of care were commonly experienced by patients with musculoskeletal disorders in outpatient rehabilitation settings. The age and health of patients were associated to these problems, but explained only a small variation in them. CLINICAL REHABILITATION IMPACT: Surveys measuring patients' experiences can be used to monitor the actual performance of rehabilitation settings and to pinpoint the exact issues needing to be addressed to improve quality as well as to make comparison among centres.

Estudio comparativo del índice de masa corporal y el equilibrio postural en estudiantes universitarios sanos / Comparative study of the body mass index and postural balance in young healthy university students

Objetivos El propósito de este estudio ha sido analizar en una población de jóvenes universitarios la influencia del índice de masa corporal (IMC) en el equilibrio general, antero-posterior y medio-lateral.Material y métodoSe ha trabajado con una muestra de 68 jóvenes (edad=20,82±3,46), 18 hombres y 50 mujeres, universitarios. Se analizó el IMC y el equilibrio con ojos abiertos y con ojos cerrados de cada uno de los sujetos.ResultadosTodas las variables estabilométricas presentan fuerte evidencia contra la normalidad. Por ello se utilizó el coeficiente de correlación Rho de Spearman. En la relación del índice de masa corporal (IMC) con el índice de estabilidad antero-posterior ojos cerrados (IAPOCX) se observan resultados estadísticamente significativos (p=0,042). El coeficiente de determinación R2=0,037 indica que la influencia del IMC sobre el IAPOCX es del 3,7%. En el resto de variables relacionadas y llevadas a estudio no se obtuvieron resultados estadísticamente significativos.ConclusionesPodemos afirmar que en ausencia de patología relevante, cuando el sujeto se encuentra con los ojos cerrados cuanto mayor es el IMC, peor es la estabilidad en el plano sagital (AU)

Objective The purpose of this study was to analyze the influence of the Body Mass Index (BMI) on the anterior-posterior and middle-lateral postural balance in young and healthy university students.Material and methodsThe study included a sample of 68 healthy university students (50 female and 18 male) aged 18-35 years old. BMI and postural balance control with both open and closed eyes were studied in each of the subjects.ResultsAll the stabilometric parameters showed strong evidence against normality. Therefore, the Spearman's rank correlation coefficient was used. Statistically significant results were found between Body Mass index (BMI) and anterior-posterior postural balance control with closed eyes (APPBCOE) (P=0.042). The R2=0.037 Coefficient of Determination showed that the influence of BMI on APPBCOE was 3.7%. No statistically significant results were obtained for the other related variables studied.ConclusionsWe can establish that, in absence of an important condition, a high BMI is related to worse postural balance control with closed eyes in the sagittal plane (AU)

Estabilometría y calidad de vida en las algias vertebrales. Un estudio transversal analítico / Stabilometry and quality of life in the spinal pain. An analytic transversal study

Objetivos. Las algias vertebrales son un problema de salud que ocasiona un alto coste socio-económico. Su fisiopatología aún no está muy clara y muchos pacientes son derivados a la Atención Especializada cuando no se obtiene una mejoría suficiente. La estabilometría permite la valoración de la insuficiencia postural. El objetivo de este estudio es comprobar la relación entre distintas variables estabilométricas y la Calidad de Vida de los pacientes afectados por raquialgias. Material y métodos. Para el estudio se seleccionaron 20 pacientes que presentaban dolor en más de un segmento raquídeo durante el último año. La variable dependiente fue la Calidad de Vida medida con la escala de Roland-Morris. Como variables independientes se tomaron las derivadas del análisis estabilométrico y de la huella plantar. Para hallar las relaciones se utilizaron el Coeficiente de Correlación de Pearson y de Spearman así como un modelo de Regresión Lineal Múltiple. Resultados. La Calidad de Vida presentó un Coeficiente de Correlación de Spearman de 0,496 (p = 0,026) con la Superficie con ojos cerrados y gomaespuma bajo los pies, un Coeficiente de Correlación de Pearson de 0,484 (p = 0,031) con la asimetría en la presión plantar y una correlación no significativa con el Cociente Total de 0,354 (p = 0,126). El modelo de regresión lineal múltiple construido explicó el 38,7 % de la varianza de la variable dependiente (p = 0,012). Conclusiones. Los datos de estudio apoyan la hipótesis de una relación positiva entre la afectación de la estabilidad y el empeoramiento de la Calidad de Vida en pacientes afectados por algias vertebrales

Objetives. The spinal pain is a problem of health that causes a high socio-economic cost. Their physiopathology is not still very clear and many patients are derived to the Secondary Care when it doesn't obtain an enough improvement. The stabilometry allows the valuation of the postural inadequacy. The objective of this study is to check the relationship among different stabilometryc variables and the Quality of the patients' Life affected by spinal pain. Methods. For the study 20 patients were selected that presented pain in more than one spinal segment during the last year. The dependent variable was the Quality of Life measured with the scale of Roland-Morris. As independent variables were taken those derived of the analysis estabilométric and of the footprint. To find the relationships were used the Pearson's Coefficient of Correlation and Spearman as well as a model of Multiple Lineal Regression. Results. The Quality of Life presented a Spearman's Coefficient of Correlation of 0,496 (p = 0,026) with the Surface with closed eyes and foam rubber under the feet, a Pearson's Coefficient of Correlation of 0,484 (p = 0,031) with the asymmetry in the sole pressure and a not significant correlation with the Total Quotient of 0,354 (p = 0,126). The model of multiple lineal regression explained 38,7 % of the variance of the dependent variable (p = 0,012). Conclusions. The study data support the hypothesis of a positive relationship between the affectation of the stability and the worsening of the Quality of Life in patients affected by spinal pain

Descripción de los procedimientos de valoración fisioterápica de las cervicalgias mecánicas / Description of the physical therapy assessment procedures of mechanical cervicalgia

Dada la elevada incidencia de las cervicalgias mecánicas entre los usuarios de nuestros servicios, hemos considerado que una correcta exploración va a garantizar la calidad de la atención fisioterápica, asegurando la posterior adecuación del tratamiento. Por ello vamos a ofrecer una descripción basada en los procedimientos de valoración fisioterápica más comúnmente aceptados y utilizados. Hemos encontrado la necesidad de estudiar las características e intensidad del dolor, realizar una exhaustiva palpación de la región cervical incluyendo la localización de las zonas álgicas y la exploración de los puntos gatillo de los principales músculos que puedan estar en relación con la existencia de una cervicalgia de origen mecánico. El estudio de la movilidad articular y la identificación de posibles disfunciones articulares serán un elemento clave de nuestra valoración. Asimismo presentamos los tests de provocación que nos van a posibilitar la inclusión o exclusión del paciente en el protocolo de tratamiento de las cervicalgias de origen mecánico (AU)

Tratamiento manipulativo articular de columna cervical / Manipulative join treatment in cervical spine

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