Adrian Escriche-Escuder

Background/Objectives The evaluation of treatment effectiveness largely depends on the outcome measures used in the study. Patient-reported outcome measures (PROMs), such as the visual analog scale (VAS), and more objective measures, such as pressure pain thresholds (PPT), are commonly employed to capture pain-sensory profiles and hypoalgesic effects. The NOD is a novel digital algometer designed to assess the PPT. This study aimed to evaluate the validity, reliability, and responsiveness of the NOD algometer using a conventional algometer as a reference instrument for PPT assessment. Methods: A prospective longitudinal study with repeated measures was conducted following the COSMIN recommendations for studies evaluating measurement properties. Healthy participants with latent trigger points were recruited from the University of Valencia, where an experimental pain induction procedure was used to generate transient changes in PPT values and evaluate the responsiveness of the NOD device. The PPT was assessed at four time points: baseline, immediately after the intervention, and at 30 and 60 min post-intervention. Results: A total of 40 participants were included in the study (mean age: 22.0 ± 3.35 years; F = 35%). For concurrent validity, a strong positive association was observed between the reference algometer and NOD (Spearman’s ρ = 0.90, p < 0.001), and the limits of agreement ranged from −1.13 to 1.34 (−25.45% to 30.18%). For reliability, intra-session reliability was good to excellent in both sessions (ICC = 0.825 and 0.859), with a standard error of measurement (SEM = 0.63 to 0.82) and minimal detectable change (MDC = 1.75 to 2.26). For responsiveness, significant reductions in NOD values were observed at all post-intervention time points compared to baseline (p ≤ 0.005). The magnitude of change increased over time, with a standardized response mean (SRM = −0.57 to −0.74) and moderate-to-large effect sizes (Cohen’s d = 0.57–0.73). Conclusions: Our findings indicate that the NOD may be a valid and reliable tool for measuring PPT at latent trigger points in healthy participants. The NOD showed a strong association with a reference algometer and good relative reliability under standardized experimental conditions. The device was also able to detect experimentally induced changes in PPT. Nevertheless, further studies are required to establish its interchangeability with conventional algometers, responsiveness to clinically meaningful change, and applicability in clinical populations.

Objectives: This study aimed to investigate the effects of nature-based immersive virtual reality (IVR) applied during dry needling (DN) on pain experienced during the procedure and on immediate and short-term post-intervention outcomes, compared with traditional DN, with a primary focus on immediate post-intervention pain intensity. Methods: In this single-blinded randomized controlled trial, participants were randomly assigned to the control (DN) or experimental (DN + IVR) group. Eligible participants were healthy individuals with identifiable latent myofascial trigger points (MTPs) in the quadriceps muscles. The primary outcome was pain intensity, measured using a numerical rating scale (NRS), immediately after the intervention. Secondary outcomes included pressure pain threshold (PPT) and pain intensity at follow-up time points (1, 6, and 24 h). Linear mixed-effects models were used to analyze the effects of group, time, and their interactions. Results: A total of 40 participants (control group, n = 21, 21.7 ± 3.1 years, 15 males; experimental group, n = 19, 22.4 ± 3.7 years, 11 males) were included. The DN + IVR group showed significantly lower pain intensity immediately after the intervention than the DN group (p = 0.032). Pain intensity decreased over time in both groups (p < 0.001), with no significant intergroup differences at later time points (all p > 0.05). For PPT, a significant effect of time was observed (p < 0.001), but no significant group × time interaction was observed. Conclusions: Nature-based IVR may reduce immediate procedural pain associated with dry needling, although these effects are not sustained over time. IVR may be a useful non-pharmacological strategy for pain relief during invasive physiotherapy procedures.

Purpose: The aims of this study were to analyze the effects of a 12-week exercise intervention on bioelectrical impedance analysis-derived phase angle (PhA), resistance (R), and reactance (Xc) in breast cancer survivors (BCS) and analyze the relationship between changes in bioelectrical impedance variables and changes in functional capacity and muscular strength. Methods: This was a prospective cohort study. Potentially eligible patients were recruited from the Medical Oncology Unit of the hospital. Female BCS older than 18 years were offered to participate in the study if they had previously undergone surgery for their primary tumor and there was no evidence of recurrence at the time of recruitment. A 12-week exercise program including resistance and endurance training was performed, including two weekly sessions led by a physical therapist. Measurements were performed at baseline and after 12 weeks, including PhA and function-related outcomes. The relationship between changes in PhA and function-related outcomes was assessed using the Pearson r correlation coefficient. Results: Sixty-seven BCS women were included in the analysis. A significant increase was found in PhA and functional outcomes after the intervention, as well as a significant decrease in R. Bivariate correlations showed a significant positive correlation between PhA and functional tests (Hand grip, r = 0.37 [p = 0.002], 30-Sit to Stand, r = 0.39 [0.002], respectively). Conclusion: A 12-week concurrent exercise program may be effective to improve PhA and R. Additionally, there appears to be a correlation between PhA and Xc with functional capacity outcomes. Finally, baseline PhA, Xc, and R values explained part of the 30-STS and hand grip tests variance at 12 weeks, which could suggest its importance in the prognosis.

Objective: This study aimed to analyze work-environment determinants that could affect emergency healthcare workers' (EHWs') personal lives in the Spanish health system. Methods: A structured self-administered questionnaire consisted of sociodemographics, work environment–related, and EHWs' personal life–related questions was sent to the professionals. Descriptive statistics were used. Bivariable and multivariable binary logistic regression analyses were performed to identify the presence of an association between the outcomes. Results: Doctors were more likely to be influenced by the stress of working and the rotating shift than other professionals. Men were less likely to be influenced by the rotating shift. Workers aged between 31 and 40 years were 6.35 times more likely to have their sleep affected by the rotating shift than workers over 51 years. Conclusion: The findings show a significant impact of work environment determinants on the personal life and well-being of EHWs' in Spain.

BACKGROUND Digitization has experienced a great growth in the last years and has emerged as a very promising tool for health interventions, but it is necessary to evaluate the variables that may influence the results of this intervention and are related with the patients such as rejection, addition, or stress due to the use of technological devices. In these terms, there is a evidence gap due to the fact there is no consensus regarding the questionnaires or scales to evaluate these variables. OBJECTIVE To synthesize the evidence about the relationship between patients and technological devices, and develop a questionnaire to measure levels of technophilia, technophobia and technostress. METHODS The systematic review included studies focused on the use of different questionnaires to evaluate the influence of technology on people. During the analysis, the data selected from each study were scale used, main variable, country and language used, sample size and study setting. In addition, for the development of the new questionnaire, Delphi procedure was used through the recruitment of ten experts, including software engineers, medical doctors, professors, and patients who completed two rounds of questionnaires. RESULTS Seven studies with a total of 3505 subjects were included. Among the studies, three of them evaluated technostress; two focused on technophobia, one assessed technophilia, and the other two studies combined the evaluation of technophobia and technophilia. Regarding the domains and items used, these were evaluated using Cronbach’s alpha scoring a range between 0.82 and 0.95. However, these results were greatly minor using other domains such as techno-communication avoidance device (0.491). Taking into account these domains, a questionnaire was constructed a priori and was refined through the two rounds of the Delphi panel, obtaining a new scale with three domains and eight items, establishing a minimum degree of agreement of 60% for priority items and 40% for secondary items. CONCLUSIONS A panel of experts were able to develop, based on the previous systematic review and on their own judgment, the eight items and the three domains to be included in the TECHNO-PROMS questionnaire, establishing a specific level of consensus, in order to plan a validation study for this scale.

(1) Background: The aim of this study was to identify the practice management software (PMS) attributes required by physiotherapists to improve software design and development in order to increase the adoption and implementation of software and minimize the impact on the workflow of the clinic. (2) Methods: In total, 27 graduated physiotherapists with clinical and management expertise and experience in management software for physiotherapy services participated in six focus groups. Research staff members recorded, transcribed, and analyzed the focus groups, using a thematic analysis to code and classify the comments. (3) Results: A total of 43 categories of coded statements divided into 12 subthemes and five broad themes were identified and compiled in two core areas of content: clinical care and administrative tasks. In order to improve the adoption and implementation of physiotherapy PMS, this research provides experiential knowledge on the inefficiencies perceived by physiotherapists regarding current software programs and the specific attributes to assist practice management and facilitate workflows. The focus group analyses led us to map the multifaceted framework for physiotherapy PMS. (4) Conclusion: These findings provide valuable information as to what aspects are meaningful for the future design and development of physiotherapy PMS, thus providing guidance to both software developers and to end-users when benchmarking software solutions.

Background: Stabilometry, the modified Star Excursion Balance Test (mSEBT) or the Emery balance test (EBT) are reported in the literature to reflect changes after an intervention in monopodal postural stability. Even so, the responsiveness of those tests has not been evaluated after an instability training programme or analysed using multiple statistical indicators of responsiveness. The main aim of this study was to analyse the responsiveness of the stabilometry, mSEBT or EBT. Methods: Thirty healthy recreational athletes performed a 4-week programme with three weekly sessions of instability training of the dominant lower limb and were evaluated using stabilometry, mSEBT, and EBT tests. Responsiveness was quantified based on internal and external responsiveness. Results: EBT and all parameters in mSEBT for the dominant lower limb showed large internal responsiveness (SRM > 0.8). Furthermore, mSEBT values for the non-dominant lower limb (except anterior displacement) also experienced significant changes with an associated large internal responsiveness. None of the stabilometry platform parameters showed a significant change after the intervention. The ability of the EBT to discriminate between the dominant and non-dominant lower limb (i.e., trained vs untrained, respectively) was generally acceptable (AUCs = 0.708). However, none of the parameters of the mSEBT test showed an acceptable AUC. Conclusions: EBT showed a positive responsiveness after instability training compared to mSEBT, which only showed internal responsiveness, or stabilometry platform measures, whose none of the parameters could identify these changes.