Non-traumatic chronic shoulder pain is not associated with changes in rotator cuff interval tendon thickness.

OBJECTIVE: To determine whether the thickness of the rotator interval tendons is different when comparing both symptomatic and non-symptomatic sides in people with chronic shoulder pain, and to those free of pain. Furthermore, to calculate the level of association between the rotator interval tendon thicknesses and perceived shoulder pain-function. DESIGN: A cross-sectional, observational study. METHOD: The supraspinatus, subscapularis and biceps brachii tendon thickness of sixty two patients with chronic shoulder pain were determined from standardized ultrasonography measures performed on both shoulders, whereas only the dominant arm was measured for the control subjects. FINDINGS: Supraspinatus, subscapularis and biceps brachii tendon thickness was comparable between sides in the symptomatic group and was also comparable between the symptomatic and asymptomatic participants. In addition, the correlation between the tendon thickness and shoulder pain-function was non-significant. INTERPRETATIONS: Tendon thickness was unaltered in people with chronic shoulder pain. These findings do not rule out the possibility that other changes in the tendon are present such as changes in the elastic properties and cell population and this should be explored in future studies.

Does the pectoralis minor length influence acromiohumeral distance, shoulder pain-function, and range of movement?

OBJECTIVE: To determine the association between pectoralis minor length (PML) and the acromiohumeral distance (AHD) in the symptomatic (S) and the asymptomatic (A) shoulder of subjects with chronic shoulder pain, and in shoulder free of pain controls (C). Furthermore, to analyze the relationship between PML and shoulder pain-function and range of movement (ROM) free of pain. DESIGN: A cross sectional study. SETTING: Primary care centres. PARTICIPANTS: A sample of fifty-four participants with chronic shoulder pain in their dominant arm was recruited, as well as fifty-four participants with shoulder free of pain. MAIN OUTCOME MEASURES: PML test and AHD measured by ultrasound. RESULTS: There was a non statistical significant correlation between PML and AHD for all the groups at both 0° (S = 0.03, p = 0.29; A = 0.06, p = 0.66; C = -0.17, p = 0.29) and 60° (S = -0.10, p = 0.84; A = -0.18, p = 0.19; C = -0.03, p = 0.84) of shoulder elevation. Likewise, there was a non statistical significant correlation between PML and shoulder pain-function (0.09, p = 0.52), and ROM (-0.13, p = 0.35). CONCLUSIONS: PML is poorly associated with AHD, as well as with shoulder pain and mobility, in people with chronic shoulder pain. Other biomechanics alterations, as well as the presence of central/peripheral sensitization should be considered.

Comparison of acromiohumeral distance in symptomatic and asymptomatic patient shoulders and those of healthy controls.

BACKGROUND: The reduction of the subacromial space has traditionally been linked to rotator cuff pathology. The contribution of this narrowing, both in the development and maintenance of rotator cuff tendinopathy, is still under debate. The objective of the present study was compare the acromiohumeral distance at 0 and 60 degrees of active shoulder abduction in scapular plane, static position, in both symptomatic and contralateral shoulders, between participants with unilateral rotator cuff related shoulder pain, and in asymptomatic participants. METHOD: This was a cross-sectional observational study. Seventy-six participants with chronic shoulder pain were assessed. Forty participants without shoulder pain were also recruited to compare the acromiohumeral distance with symptomatic participants. The acromiohumeral distance was measured at 0 and 60 degrees of active shoulder abduction in all the groups by ultrasound imaging. Mean differences between symptomatic versus contralateral shoulders, and versus healthy controls, were calculated. FINDINGS: There were no statistical significant differences (p > .05) in the acromiohumeral distance at 0 degrees of shoulder elevation between the groups. However, significant differences were found at 60° between symptomatic and contralateral shoulder groups (0,51 mm; 95% CI: -0.90 to -0.12). INTERPRETATIONS: Differences in shoulder pain perception at 0° are not attributable to acromiohumeral distance differences. However, treatments focused on increasing AHD at 60° could be prescribed, as a significantly reduced AHD was found in symptomatic shoulders when compared with contralateral shoulders. Further research is needed to determine, not only static differences in AHD, but also dynamic differences.

Is coracohumeral distance associated with pain-function, and shoulder range of movement, in chronic anterior shoulder pain?

BACKGROUND: The aim of this study was twofold: (i) to assess the intrarater reliability of coracohumeral distance; (ii) to investigate the level of association between coracohumeral distance measured by ultrasonography, and pain-disability and shoulder range of movement, in patients suffering from chronic anterior shoulder pain. METHODS: An observational, cross sectional study was carried out. A convenience sample comprised of 87 patients with chronic anterior shoulder pain was assessed from 3 primary care centres. Main outcomes as pain and function were measured through the shoulder pain and disability index. Furthermore, shoulder range of movement-free of pain in shoulder elevation, as well as coracohumeral distance at both 0 and 60 degrees, were collected. RESULTS: Absence of any correlation was found between coracohumeral distance and shoulder pain and disability index at both 0 and 60 degrees of shoulder elevation. Furthermore, absence of any correlation was found between coracohumeral distance measurements and active shoulder range of movement -free of pain. CONCLUSIONS: There was poor association between coracohumeral distance and shoulder pain and function, as well as with shoulder range of movement, in patients with chronic anterior shoulder pain. Hence, clinicians should consider, not only increasing this space, but also other possibilities in their therapies, when patients with anterior shoulder pain are treated. TRIAL REGISTRATION: ACTRN12614000144617 . Registered: 1st March 2014.

Obesidad, actividad física y dolor lumbar: un análisis genéticamente informativo / Obesity, physical activity and low back pain: a genetically informative analysis

Objetivo: Analizar la relación entre obesidad, actividad física y dolor lumbar a través de un estudio transversal de gemelos caso-control. Material y método: La muestra general la componen 1.613 individuos gemelos, de entre 47 y 73 años, y participantes en el Registro de Gemelos de Murcia. Los datos fueron obtenidos mediante entrevista telefónica y se recogió información sobre dolor de espalda, datos antropométricos y actividad física. La cigosidad fue evaluada mediante cuestionario. El análisis caso-control se realizó sobre 199 parejas completas y discordantes para dolor lumbar. Resultados: La prevalencia del dolor lumbar en la muestra total fue del 33,1% (mujeres: 36,4%; varones: 29,1%). El Índice de Masa Corporal (IMC) fue de 27.2 (DE: 4,3). En la muestra general, ser mujer, IMC elevado, frecuencia baja de actividad física moderada e intensa y sedentarismo se asociaron con mayor riesgo de padecer dolor lumbar. Sin embargo, todas las asociaciones perdieron significación estadística en el análisis caso-control. Conclusión: Es necesario considerar las características individuales o grupales al valorar el papel del IMC o la actividad física en la prevención del dolor lumbar. Esto incluye la necesidad de tener en cuenta el papel de los factores genéticos en futuras investigaciones sobre esta relación (AU)

Objective: Our main objective was to analyse the relationship between obesity, physical activity and low back pain using a cross-sectional co-twin design. Material and method: The total sample comprised 1,613 subjects, aged 47 to 73, from the Murcia Twin Registry. Data were obtained through telephone interview, and information about back pain, anthropometric data and physical activity was collected. One-hundred and ninety-nine pairs complete and discordant for low back pain were available for the case-control analysis. Results: Prevalence of low back pain was 33.1% (females: 36.4%; males: 29.1%). Mean Body Mass Index (BMI) was 27.2 (SD: 4.3). For the general sample, being female, a high BMI, low frequency of moderate or intense physical activity and sedentarism were associated to a higher risk of low back pain. However, all associations lost statistical significance in the case-control analyses. Conclusion: Individual and group characteristics must be considered when evaluating the role of BMI or physical activity on prevention of low back pain. This includes the need to take into account the role of genetic factors in future research about this relationship (AU)

Prevalencia y factores de riesgo de dolor pélvico / Prevalence and risk factors of pelvic pain

Objetivos: Determinar la prevalencia de síntomas de dolor pélvico crónico (DPC) en Málaga y provincia y detectar los factores de riesgo asociados. Método: Estudio transversal entre habitantes de Málaga y provincia con edades comprendidas entre los 18 y 65 años; muestreo no probabilístico por cuotas (n = 887; 414 mujeres y 473 hombres), estratificado por sexo, edad y comarcas. Todos cumplimentaron el CDPC-M, herramienta validada por su capacidad discriminativa entre sujetos con DPC y sujetos que no lo padecen. Resultados: la prevalencia de síntomas de DPC en sujetos entre 18-65 años fue de 22,8% en la población en general (30,9%: mujeres y 15,6%: hombres) (RR = 1.974 mujeres frente a hombres, IC 95%: 1,53-2,55, p < 0,001). Tras corregirse por sexo y edad, los individuos que practican actividad física presentan una menor puntuación en CDPC-M que los que no la hacen (diferencia de medias −0,65 ± 0,27). Los siguientes factores se asocian significativamente a mayor puntuación en la escala: levantar y/o mover carga en actividades de la vida diaria (1,34 ± 0,33), la ingesta de laxantes y/o dieta rica en fibra (2,09 ± 0,48), haber sufrido en el pasado enfermedad infecciosa urogenital -vulvovaginitis, cistitis y prostatitis- (1,77 ± 0,55), hemorroides/fisura anal (1,31 ± 0,40) o traumatismo pélvico (1,21 ± 0,61) respectivamente. En relación con los hábitos posturales solo las horas que el sujeto pasa en bipedestación muestran tendencia a presentar mayores puntuaciones en CDPC-M (coeficiente de regresión ajustado por sexo y edad de 0,078 puntos/hora; EE = 0,04; p < 0,068). Conclusiones: Alta prevalencia de síntomas de DPC en Málaga (22,8%), relacionada significativamente con diversos factores de riesgo

Objectives: To determine the prevalence of chronic pelvic pain (CPP) symptoms in Malaga and its province and to identify associated risk factors. Method: A cross-sectional study was carried out in Malaga and its province, involving subjects aged 18-65 years throughout a non-probability sampling by quotas (n = 887), stratified by sex, age and counties. All participants completed the QCPP-M, a self-administered questionnaire, validated tool due to its ability to discriminate patients with and without CPP. Results: Prevalence of symptoms of CPP in subjects aged between 18 and 65 years was 22.8% in general population (30.9% women and 15.6% men) (RR = 1.974 for women versus men, 95% CI 1.53-2.55, P < 0.001). After correction by sex and age individuals who practice physical activity had a lower score in QCPP-M than others who did not (mean difference −0.65 ± 0.27). They were significantly associated with higher scores in the following factors: lifting and/or moving weights in activities of daily life (1.34 ± 0.33), laxatives intake and/or high-fiber diet (2.09 ± 0.48), and having suffered from urogenital infectious disease in the past: vulvovaginitis, cystitis and prostatitis (1.77 ± 0.55), hemorrhoids/anal fissure (1.31 ± 0.40) or pelvic trauma (1.21 ± 0.61) respectively. Individuals who spend more time standing had a tendency to have higher scores on QCPP-M (coefficient of regression adjusted for sex and age of 0.078 points/h, SE = 0.04, P < 0.068). Conclusions: High prevalence of CPP symptoms in Málaga (22.8%); this is related to several significant risk factors

Prevalence and risk factors of pelvic pain.

OBJECTIVES: To determine the prevalence of Chronic Pelvic Pain (CPP) symptoms in Malaga and its province and to identify risk factors associated. METHOD: a cross-sectional study was carried out in Malaga and its province, 18-65 years-old throughout a non-probability sampling by quotas (n = 887), stratified by sex, age and counties. All participants completed the QCPP-M, a self-administered questionnaire, validated tool due to its ability to discriminate patients with and without CPP. RESULTS: prevalence of symptoms of CPP in subjects between 18-65 years-old was 22.8% in general population (30.9% women and 15.6% men) (RR = 1.974 for women versus men, 95% CI 1.53-2.55, P < .001). After correction by sex and age individuals who practice physical activity had a lower score in QCPP-M that others who do not not (mean difference -0.65 ± 0.27). They were significantly associated with higher scores in the following factors: lifting and/or moving weights in activities of daily life (1.34 ± 0.33), laxatives intake and/or high-fiber diet (2.09 ± 0.48), having suffered from urogenital infectious disease in the past: vulvovaginitis, cystitis and prostatitis (1.77 ± 0.55), hemorrhoids/anal fissure (1.31 ± 0.40) or pelvic trauma (1.21 ± 0, 61) respectively. Individuals who spend more time standing had a tendency to have higher scores on QCPP-M (coefficient of regression adjusted for sex and age of 0.078 points/hour, SE = 0.04, P < .068). CONCLUSIONS: High prevalence of CPP symptoms in Málaga (22.8%), this is related with significantly several risk factors.

Short term effects of kinesiotaping on acromiohumeral distance in asymptomatic subjects: a randomised controlled trial.

OBJECTIVES: The first aim of this study was to investigate whether kinesiotaping (KT) can increase the acromiohumeral distance (AHD) in asymptomatic subjects in the short term. The second aim was to investigate whether the direction of kinesiotaping application influences AHD. BACKGROUND: In recent years, the use of KT has become increasingly popular for a range of musculoskeletal conditions and for sport injuries. To date, we are unaware of any research investigating the effect of kinesiotaping on AHD. Moreover, it is unknown whether the direction of kinesiotaping application for the shoulder is important. METHODS: Forty nine participants were randomly assigned to one of three groups: kinesiotaping group 1 (KT1), kinesiotaping group 2 (KT2) and sham kinesiotaping (KT3). AHD ultrasound measurements at 0° and 60° of shoulder elevation were collected at baseline and immediately after kinesiotape application. RESULTS: The results showed significant improvements in AHD after kinesiotaping, compared with sham taping. The mean difference in AHD between KT1 and KT3 groups was 1.28 mm (95% CI: 0.55, 2.03), and between KT2 and KT3 was 0.98 mm (95% CI: 0.23, 1.74). Comparison of KT1 and KT2 groups, which was performed to identify whether the direction of taping influences the AHD, indicated there were no significant differences. CONCLUSION: KT increases AHD in healthy individuals immediately following application, compared with sham kinesiotape. No differences were found with respect to the direction in which KT was applied.

Relación entre el test de elevación de pierna recta y el test ángulo poplíteo en la medición de la extensibilidad isquiosural / Relationship between straight leg raise (SLR) and active knee extension (AKE) test measurements in hamstrings flexibility

Objetivos Establecer la relación entre los test de elevación de pierna recta (EPR) y active knee extension (AKE, «ángulo poplíteo») en la medición de la extensibilidad isquiosural, determinar el grado de fiabilidad de cada test, determinar la influencia ejercida de un test sobre otro y establecer el grado de extensibilidad isquiosural en los universitarios, así como las diferencias entre géneros.Material y método Se ha llevado a cabo un diseño experimental aleatorio transversal. 19 sujetos, 11 mujeres y 8 hombres, se presentaron voluntariamente al estudio. De ellos, 2 mujeres fueron excluidas por haber padecido dolor lumbar en el último mes. Fueron repartidos en dos grupos de forma aleatoria, un grupo fue sometido al test EPR seguido del AKE, mientras que el grupo 2 fue sometido al test AKE seguido del EPR, con 6 min entre test y test, con dos intentos para cada test con 1min entre ensayo y ensayo. Resultados No encontramos una relación estadísticamente significativa entre AKE y EPR, medida por un coeficiente de determinación del 0,420. En cuanto a fiabilidad, los resultados fueron 0,866 en AKE y de 0,741 en EPR. La realización de un test no condicionó el resultado del siguiente test y se hallaron resultados más altos en el hombre con respecto a la mujer.ConclusiónEPR y AKE no miden por igual la extensibilidad isquiosural, siendo AKE más fiable que EPR. Un test no influyó en la realización posterior del otro y se encontraron datos más altos de extensibilidad en hombres que mujeres, siendo necesaria más investigación para poder concluir sobre este aspecto (AU)

Objective To determine the relationship between straight leg raise (SLR) test and active knee extension (AKE) in hamstrings flexibility measurement, reliability of each test, influence of one test over the other and establish the differences between the university students and gender in hamstrings range of motion. Materials and methods A randomized, cross-sectional, experimental design study was conducted. Nineteen healthy subjects (11 women, 8 men) voluntarily participated in the study. Two women were excluded to de having had low back pain in the last month. The subjects were randomly assigned to groups 1 and 2. Group 1 performed the SLR first and then the KEA and Group 2 performed the KEA first and then the SLR. The subjects had 6 min between the two test, with two attempts for each test with a one-minute rest period SLR1 and SLR2 and AKE1 and AKE2, respectively.Results There was no statistically significant relationship between AKE and SLR measurements, with a coefficient of determination of 0.421. Reliability of SLR was 0.741 and 0.866 in AKE. No influence was found between both test and we found a higher range of movement in the male than in female.Conclusions SLR and AKE does not measure hamstrings flexibility equally. We obtained more reliable results with the AKE. One test did not influence the subsequent performance of the other and higher data on extensibility were found in men than in women. However, future research is needed to make a conclusion on this aspect (AU)

Fisioterapia y esclerosis lateral amiotrófica / Physioterapy and esclerosis lateral amiotrofica

La esclerosis lateral amiotrófica (ELA) es una enfermedad de la motoneurona superior e inferior, con afectación bulbar variable, sin alteraciones mentales, sensitivas, sensoriales ni esfinterianas. El objetivo de este trabajo es aportar nuestra experiencia profesional como fisioterapeutas, proponiendo un protocolo de exploración y tratamiento de estos pacientes, aunque destacando la importancia del tratamiento individualizado, que debe ser revisado y adaptado periódicamente según la situación clínica del sujeto (AU)