Javier Güeita-Rodríguez

Objective: To describe the experience of pain among people with Parkinson's disease, including its characteristics, psychological effects, and impact on daily life. Design: Qualitative descriptive study. Setting: Community-based study using semi-structured individual interviews. Participants: Fifteen people with Parkinson's disease (11 women) diagnosed according to the United Kingdom Parkinson's Disease Society Brain Bank criteria and experiencing Parkinson's disease-related pain based on the Parkinson's Disease Pain Classification System. Intervention: Not applicable. Main measures: Semi-structured interviews were conducted to explore participants’ experiences of pain. Data were analysed using an inductive thematic analysis based on a hybrid approach combining artificial intelligence-powered coding through ChatGPT-4 with manual triangulation. Results: Three main themes were identified: (1) experiences and perceptions of pain, including the nature and characterization of pain and its relationship with Parkinson's disease; (2) the impact of pain on daily life; and (3) feelings associated with pain, including emotional changes related to pain and its broader psychological impact. Conclusions: Pain in people with Parkinson's disease is an interconnected and context-dependent experience extending beyond its physical manifestations. The patient-centred narratives provide contextual insight into how pain interacts with motor and non-motor symptoms, daily functioning, emotional well-being, and participation, supporting individualized and comprehensive approaches to pain assessment and management.

Background and Objective: Research on aquatic interventions for children with autism spectrum disorder (ASD) has spanned over four decades, yet the field remains characterized by a fragmented evidence where therapeutic techniques often coexist without a unifying conceptual logic. This has led to a translational gap between research findings and clinical decision-making. This narrative review aimed to synthesize four decades of research into an evidence-informed clinical reasoning framework to capture the evolution of aquatic therapeutic practice and support clinical decision-making. Methods: Literature search was conducted in PubMed, Scopus, and Web of Science, covering publications from the earliest available records to May 2026. Studies were analysed according to their therapeutic concepts, clinical reasoning logic, and outcome domains. Results: A total of 30 studies met the inclusion criteria and were included in this review. The resulting synthesis enabled the derivation of an evidence-informed clinical reasoning framework representing five dominant therapeutic perspectives that characterize the development of aquatic clinical reasoning across the literature. By synthesizing peer-reviewed literature, we identified five dominant clinical reasoning paradigms that emerged across the development of the literature and continue to inform contemporary aquatic practice: (1) Exploratory and Sensory-Regulatory, (2) Skill- and Safety-Oriented, (3) Structured and Functional, (4) Participation- and Social-Oriented, and (5) Individualized and Outcome-Informed Practice. Conclusions: This conceptual roadmap may help clinicians align aquatic intervention strategies with individual therapeutic priorities, functional goals, and participation needs. The proposed framework provides a bridge between historical practice and contemporary evidence, supporting individualized and outcome-informed clinical reasoning in aquatic therapy for children with ASD. The five phases should be interpreted as dominant paradigms of clinical reasoning that may coexist within practice rather than as mutually exclusive or strictly chronological categories.

Background/Objectives: Nursing home residents were among the most vulnerable populations during the COVID-19 pandemic, facing strict restrictive measures, limited access to medical services, and significant psychological consequences derived from institutional confinement. Despite the magnitude of these impacts, the perspective of residents themselves remain underrepresented in the qualitative literature, particularly in the Spanish context. The aim of this study was to analyze and describe the perspectives of residents in a nursing home regarding the restrictive measures adopted by the facility and their access to medical services during the COVID-19. Methods: An exploratory qualitative study was conducted with 24 residents of a nursing home in Cáceres, Spain. Data were collected through in-depth interviews and field notes, and analyze using inductive thematic analysis following Braun and Clarke’s framework. Results: Two main themes were identified: Necessary to feel safe, but unpleasant: accepting the restrictive measures (Accepting the measures; and Better safe, even if unpleasant) and Barriers to healthcare: abandonment, fear, and age-based exclusion (Neglect and abandonment by healthcare system; The residence as a “bubble” and fear of hospital transfer; and Not treated because of our age). Conclusions: The findings highlight the complexity of the experiences of older adults in residential care during the COVID-19 pandemic and underscore the urgent need to balance health protection with psychological well-being, dignity, and the rights of older people in future emergency responses.

Background: Physiotherapy education combines theoretical instruction with practical training, and evidence supports the integration of digital learning and laboratory-based experiences. The flipped classroom has gained prominence in health professions education, demonstrating positive effects on student engagement and academic outcomes. However, little is known about the integration of this methodology within motion analysis laboratories in physiotherapy curricula. Objective: To evaluate the implementation of an educational innovation project integrating digital resources, flipped classroom methodology, and laboratory-based gait analysis sessions within a fourth-year physiotherapy course. Methods: A longitudinal observational study was conducted with physiotherapy students at Rey Juan Carlos University (Spain) between 2020–2021 and 2024–2025. The intervention included digital learning resources (podcasts and videos), flipped classroom seminars, and a gait analysis workshop using a motion capture system. Academic performance was assessed through multiple-choice examinations. Student satisfaction with digital resources, methodology, and practical seminars was evaluated using Likert-type questionnaires. Welch’s ANOVA was used to compare cohorts. Results: A total of 549 students were included in the performance analysis and 188 in the satisfaction survey. Academic outcomes improved during the years in which the project was implemented, with increased rates of distinction and outstanding grades and reduced fail rates. The year without the intervention showed the poorest performance. Student satisfaction was high, with strong ratings for methodology, teaching staff, facilities, and seminar usefulness. Podcasts and the laboratory seminar received excellent evaluations. Conclusions: The integration of digital tools, flipped classroom strategies, and laboratory-based learning enhances student satisfaction and academic performance in physiotherapy education, strengthening the link between theory and clinical practice.

The process of returning to participation after a stroke depends on various individual and contextual factors, yet little is known about those with slight dependency. This study aimed to explore the experiences of people with mild sequelae after stroke in relation to their return to participation, considering the socio-cultural context of Spain. A qualitative phenomenological study was conducted involving 35 mild stroke survivors walking independently. The participants had experienced a stroke at least 6 months earlier. Data collection consisted of semi-structured interviews and researchers' field notes. The analysis was conducted following Giorgi's method. Three themes were obtained: (a) Intrapersonal context: resilience to face sequelae and achieve autonomy, self-reflections; (b) Return to daily life: home and leisure, work and study, daily community and travel; and (c) Interpersonal and social participation reengage: close connections, social bonds. Our findings suggest that returning to participation after a mild stroke is a highly heterogeneous process and is shaped by social support, adaptations facilitating independence, self-determination, and the development of post-stroke roles. Individuals with lived experience engaged in the analysis and verification of the presented data. Their input helped ensure that the findings were interpreted in a way that reflects real-world perspectives and relevance. No patient or public involvement occurred during the design or conduct of the study, or in the preparation of the manuscript.

Introduction: The process of returning to participation after a stroke depends on various individual and contextual factors, yet little is known about those with slight dependency. This study aimed to explore the experiences of people with mild sequelae after stroke in relation to their return to participation, considering the socio‐cultural context of Spain. Method: A qualitative phenomenological study was conducted involving 35 mild stroke survivors walking independently. The participants had experienced a stroke at least 6 months earlier. Data collection consisted of semi‐structured interviews and researchers' field notes. The analysis was conducted following Giorgi's method. Findings: Three themes were obtained: (a) Intrapersonal context: resilience to face sequelae and achieve autonomy, self‐reflections; (b) Return to daily life: home and leisure, work and study, daily community and travel; and (c) Interpersonal and social participation reengage: close connections, social bonds. Conclusion: Our findings suggest that returning to participation after a mild stroke is a highly heterogeneous process and is shaped by social support, adaptations facilitating independence, self‐determination, and the development of post‐stroke roles. Patient or Public Contribution: Individuals with lived experience engaged in the analysis and verification of the presented data. Their input helped ensure that the findings were interpreted in a way that reflects real‐world perspectives and relevance. No patient or public involvement occurred during the design or conduct of the study, or in the preparation of the manuscript.

To study the feasibility of a Water Specific Therapy (WST) program in subjects with incomplete spinal cord injury (iSCI) and <6 months since injury. Secondary: To analyze the impact on balance and gait. Pilot study with single-subject repeated-measures. Rehabilitation center. Twelve individuals with subacute (≤6 months) motor iSCI (T1-L5). WST program comprising 18 sessions, 40-minute-long, including warm up, balance training, aerobic exercises, and cool-down, monitored via the Rating of Perceived Effort scale. Feasibility was assessed through adherence to treatment, safety and attrition rate. Self-perceived improvement (balance, gait, and lower limb strength) and difficulties encountered by physical therapists were also evaluated. Secondary outcomes included the Berg Balance Scale (BBS), Timed Up and Go test, 10-meter walk test (10-MWT), 6-minute walk test (6-MWT), and Walking Index for Spinal Cord Injury II (WISCI-II). Adherence to treatment reached 83%, with only two unrelated dropouts. No adverse effects were recorded, deeming the treatment safe. Self-perceived improvements were noted by 88.9% of subjects, with moderate and substantial gains in the three reported variables. Physiotherapists referred difficulties in reaching intensity targets, prompting program adaptations. Statistical significance (P < 0.05) was reached in BBS, 10-MWT, 6-MWT and WISCI-II outcomes. WST is a feasible, safe, well-accepted method for treating subacute iSCI, potentially enhancing gait and balance in these subjects. Individualized program adaptations may be required. Controlled studies are warranted to determine it is effectiveness.Trial registration: ClinicalTrials.gov identifier: NCT03962218..

(1) Background: This study investigates the experiences of prisoners with serious mental disorders who participated in a two-month dog-assisted therapy program within a Spanish prison. The aim was to understand the emotional and psychosocial impacts of the program on this population. (2) Methods: A qualitative descriptive design was used with purposeful sampling of sixteen prisoners (mean age 43.4) who completed the program. Data were collected through in-depth interviews and analyzed using thematic analysis to identify key themes. (3) Results: Participants reported a positive emotional impact, highlighting the significance of bonding, love, and reciprocal affection with the therapy dog. They emphasized the dog’s unconditional nature as a source of comfort and connection. The importance of supportive relationships with the therapists who guided the sessions was also noted. Additionally, participants reflected on their motivations for joining the program and described progressive emotional changes over the course of their participation. (4) Conclusions: Dog-assisted therapy shows potential as a psychosocial intervention to enhance the prison experience for individuals with serious mental disorders. By fostering emotional well-being and positive connections, it may contribute to improved rehabilitation outcomes and better quality of life for this population.

This study describes the experience of parents of children with developmental and epileptic encephalopathies (DEE) and how the disease impacts their daily lives. A descriptive qualitative study was conducted using purposeful sampling. Twenty-one parents of children with DEEs caused by SCN1A, KCNQ2, CDKL5, PCDH19, and GNAO1 variants were included. Data collection was based on in-depth interviews and researchers' field notes. An inductive thematic analysis was performed. Five themes emerged: (a) the diagnostic process, which describes the path from the time parents recognize the first symptoms until diagnostic confirmation is obtained; (b) the relationship with health professionals during the search for a diagnosis, which describes how the entire process is conditioned by the relationships established; (c) the world of disability, revealing how the disease and disability impact the life of the parents; (d) living day to day, the parents continuously change their plans in anticipation of the onset of a seizure; (e) the disease progression, a cause of great concern in the parents. Our results show the need to develop recovery programs that integrate health and social interventions to support parents of children with DEE in the process of diagnosis and disease management.

BackgroundStroke survivors exhibit sedentary behavior, and many do not engage in physical activity and exercise for a number of reasons. Secondary prevention through physical activity is a priority to avoid a new stroke or disease.ObjectiveTo describe the experience of stroke survivors with maintained walking ability living in Spain regarding physical activity and exercise.MethodsA qualitative phenomenological study was conducted. Purposive sampling was carried out to include 35 stroke survivors who had stroke more than 6 months ago from 14 neurorehabilitation centers in 24 cities in Spain. Data were collected through semi-structured interviews and researchers' field notes. The Giorgi approach was used for the qualitative analysis of the data collected.ResultsThree themes emerged: a) Changes in the experience of physical activity and exercise adaptation; b) Reasons for and against the practice of physical activity and exercise; c) Experiencing tiredness and fatigue.ConclusionsOur results show the individual post-stroke perception of each person, the reasons for and against the practice of physical activity and exercise, as well as the impact this has on their daily life and activity. These results will help health professionals to understand the needs of stroke survivors when prescribing physical activity and exercise included in intervention programs.