Elisabeth Bravo-Esteban

Background and objectives: This randomized controlled trial aimed to evaluate the effectiveness of an 8-week combined lumbar motor control and hip muscle strengthening program in individuals with chronic non-specific low back pain (NSLBP). Methods: Fifty-four adults with chronic NSLBP were randomized to a combined lumbar motor control and hip muscle strengthening program (n = 27) or lumbar motor control alone (n = 27). The intervention comprised 24 in-person sessions over 8 weeks. Pain intensity and disability were assessed before and after treatment using the Visual Analogue Scale (VAS) and Oswestry Disability Index (ODI), respectively. CONSORT recommendations were followed. Results: Both groups achieved meaningful improvements from baseline, showing a median pain reduction of 15 mm and a median disability reduction of 5 points in the experimental group and 4 points in the control group. However, between-group comparisons revealed no statistically significant differences for either pain (p = 0.165) or disability (p = 0.380). Clinically meaningful individual improvements were achieved by 55.6% of the experimental group versus 51.9% of controls for pain intensity (p ≥ 0.05), and by 44.4% versus 25.9% for disability (p ≥ 0.05), respectively. Conclusions: Both interventions effectively reduced pain and disability. However, adding hip strengthening cannot be considered superior to lumbar motor control alone.

Background and objectives: Primary dysmenorrhea is a major contributor to chronic pelvic pain. It negatively impacts quality of life. Therapeutic exercise has become recognized as a non-pharmacological alternative for reducing the severity of symptoms. Methods: A systematic review and meta-analysis were conducted in accordance with the PRISMA guidelines. Randomized controlled trials involving adult women with primary dysmenorrhea who underwent therapeutic exercise interventions were selected. Databases searched were Embase, PubMed, Scopus, CENTRAL, Web of Science, ProQuest, PEDro, and CINAHL up to 31 January 2026. The main variables were symptom severity, pain intensity, and duration. The secondary outcomes were quality of life, anxiety, and sleep quality. The Cochrane’s Risk of Bias 2 tool was used to assess the risk of bias, while the certainty of evidence was determined using GRADE. Results: Twenty-nine studies (1704 participants) were included. Therapeutic exercise significantly improved symptom severity (SMD = −0.91), pain intensity (SMD = −2.17), and duration (SMD = −0.70), and enhanced quality of life (SMD = 0.70) and sleep quality (SMD = 0.33). These results were maintained into the second menstrual cycle after the intervention. I² values were high across all outcomes. Subgroup analysis revealed a greater effect of mind–body and stretching interventions on symptom severity, and of aerobic and strength exercise on pain intensity. The certainty of the evidence was low to very low. Conclusions: Therapeutic exercise appears effective for improving the severity of primary dysmenorrhea and associated symptoms, although caution is warranted when interpreting these conclusions due to the insufficient certainty of the evidence.

Bioelectrical impedance analysis (BIA) is a widely used method for estimating body composition, and its accuracy may be influenced by various factors, including bladder filling. This study aims to investigate the impact of bladder filling on the accuracy of BIA measurements. An experimental crossover study was conducted with sedentary young adults. The influence of bladder filling on total body water (TBW), fat mass (FM), fat-free mass (FFM), and basal metabolic rate (BMR) was assessed. Participant in underwear followed an overnight fast. They were instructed to abstain from vigorous physical activity and alcohol for at least 24 h prior to the session. The results obtained from single-frequency and multi-frequency BIA devices were compared. The findings suggest that bladder filling does not affect measured impedance; however, changes in weight following bladder voiding influenced derived BIA results. Specifically, TBW, FM, and BMR values significantly reduced after voiding (p < 0.05). Furthermore, the study found poor agreement between single-frequency and multi-frequency BIA devices, indicating that they are not interchangeable. Bladder filling does affect BIA measurements, not clinically meaningful. Further research is needed to explore the implications of these findings for clinical practice and research protocols.

El objetivo principal de este estudio fue la elaboración e implementación de una actividad transversal para la mejora de la coordinación de asignaturas e integración de competencias, en los alumnos de primer curso de Grado en Fisioterapia de la UCLM. Para ello se crearon dos grupos de estudiantes: un grupo de intervención que realizó la actividad de integración propuesta, y un grupo control que siguió la metodología tradicional. No se encontraron diferencias estadísticamente significativas con respecto a los resultados académicos, ni a la satisfacción global de los estudiantes entre ambos grupos. No obstante, se ha observado una mayor motivación en los estudiantes pertenecientes al grupo experimental. Se proponen mejoras en la metodología empleada, estrategias óptimas para tareas grupales equitativas, e incentivar al estudiante sobre la importancia de la integración de conocimientos. Pérez Nombela, Soraya; Agulló Ortuño, Mª Teresa; Lirio Romero, Cristina; Prieto Gómez, Virginia; Arranz Martín, Beatriz; Bravo Esteban, Elisabeth; Arroyo Fernández, Rubén; Torres Martín; Palomo Carrión; Martínez Galán, Inés

Correct blinding is essential for preventing potential biases. The aim of this study was to assess the blinding of participants and a therapist following treatment with transcranial direct current stimulation in subjects with fibromyalgia using James’ and Bang’s blinding indexes. Eighty subjects were randomly allocated either active or sham stimulation groups in an intervention of five sessions lasting 20 min each. A questionnaire was delivered to both the therapist and patients after the last session to record their guess of which treatment had been applied. No differences between the groups were noted at baseline in terms of demographic or clinical data. James’ BI was 0.83 (CI 95%: 0.76–0.90) for the patients and 0.55 (CI 95%: 0.45–0.64) for the therapist. Bang’s BI for subjects was −0.08 (CI 95%: −0.24–0.09) and −0.8 (CI 95%: −0.26–0.1) for the active and sham transcranial direct current stimulation groups, respectively. Bang’s BI for the therapist was 0.21 (CI 95%: −0.02–0.43) and 0.13 (CI 95%: −0.09–0.35) for the active and sham transcranial direct current stimulation groups, respectively. Protocols of active and sham transcranial direct current stimulation applied in this study have shown satisfactory blinding of the therapist and subjects with fibromyalgia.

The capacity of children with hemiplegia to be engaged in anticipatory action planning is affected. There is no balance among spatial, proprioceptive and visual information, thus altering the affected upper limb visuomotor coordination. The objective of the present study was to assess the improvement in visuomotor coordination after the application of a unimanual intensive therapy program, with the use of unaffected hand containment compared with not using unaffected hand containment. A simple blind randomized clinical trial was realized. A total of 16 subjects with congenital infantile hemiplegia participated in the study with an age mean of 5.54 years old (SD:1.55). Two intensive protocols for 5 weeks of modified constraint-induced movement therapy (mCIMT) or unimanual therapy without containment (UTWC) were executed 5 days per week (2 h/day). Affected upper limb visuomotor coordination (reaction time, task total time, active range, dynamic grasp) was measured before–after intensive therapy using a specific circuit with different slopes (10°/15°). Statistically significant inter-group differences were found after the intervention, with clinically relevant results for the mCIMT group not seen in UTWC, in the following variables: reaction time 10°slope (p = 0.003, d = 2.44), reaction time 15°slope (p = 0.002, d = 2.15) as well as for the task total time 10°slope (p = 0.002, d = 2.25), active reach 10°slope (p = 0.002, d = 2.7), active reach 15°slope (p = 0.003, d = 2.29) and dynamic grasp 10°/15°slopes (p = d = 2.69). There were not statistically significant inter-group differences in the total task time with 15°slope (p = 0.074, d = 1.27). The use of unaffected hand containment in mCIMT would allow improvements in the affected upper limb’s visuomotor coordination. Thus, it would favor clinical practice to make decisions on therapeutic approaches to increase the affected upper limb functionality and action planning in children diagnosed with infantile hemiplegia (4–8 years old).

This study aimed to determine the effect of one session of dry needling on the severity of tremor, motor function and skills, and quality of life of a 39-year-old woman with post-stroke tremor. Myofascial trigger points (MTrP) of the following muscles were treated: extensor digitorum, flexor digitorum superficialis and profundus, brachioradialis, short head of biceps brachii, long head of triceps brachii, mid deltoid, infraspinatus, teres minor, upper trapezius, and supraspinatus. Outcomes were assessed via (i) clinical scales (activity of daily living (ADL-T24), a visual analog scale (VAS), and the Archimedes spiral), (ii) a functional test (9-Hole Peg test), and (iii) biomechanical and neurophysiological measurements (inertial sensors, electromyography (EMG), and dynamometry). The subject showed a decrease in the severity of tremor during postural (72.7%) and functional (54%) tasks after treatment. EMG activity decreased after the session and returned to basal levels 4 days after. There was an improvement post-intervention (27.84 s) and 4 days after (32.43 s) in functionality and manual dexterity of the affected limb, measured with the 9-Hole Peg test, as well as in the patient’s hand and lateral pinch strength after the treatment (26.9% and 5%, respectively), that was maintained 4 days later (15.4% and 16.7%, respectively).