César Calvo-Lobo

Background/Objectives: Shoulder pain in tennis players is usually interpreted from a local shoulder perspective, although kinetic-chain and trunk-control factors may also be relevant. The diaphragm contributes to breathing and trunk stabilization, but diaphragm-related measures have received limited attention in tennis players with shoulder pain. This study compared inspiratory muscle strength, diaphragm thickness, and diaphragm thickening fraction between tennis players with and without non-specific shoulder pain. Methods: This observational cross-sectional study included 64 tennis players: 32 with non-specific shoulder pain and 32 asymptomatic controls. Maximum inspiratory pressure (MIP), bilateral diaphragm thickness during relaxed inspiration and expiration, and diaphragm thickening fraction were assessed. Between-group differences were analyzed. Results: Tennis players with non-specific shoulder pain showed lower MIP than controls (p = 0.002). Diaphragm thickness during relaxed inspiration was lower in symptomatic players on the left (false discovery rate (FDR)-adjusted p = 0.033) and right sides (FDR-adjusted p = 0.012), and diaphragm thickening fraction was also lower bilaterally (left: FDR-adjusted p = 0.036; right: FDR-adjusted p = 0.039). Conclusions: Tennis players with non-specific shoulder pain showed lower inspiratory muscle strength, lower bilateral diaphragm thickness during relaxed inspiration, and lower bilateral diaphragm thickening fraction than asymptomatic players. These cross-sectional findings describe group-level differences but do not establish causality, diaphragm dysfunction, or clinical relevance.

Background: Hallux limitus (HL) is a restriction of first metatarsophalangeal joint dorsiflexion, commonly linked to foot biomechanics-related disorders or trauma, increasing sports injury risk. It involves plantar fascia tension, compensations, and tendon adaptations. Rehabilitative ultrasound imaging (RUSI) accurately assesses musculoskeletal changes, supporting physiotherapy evaluation and the study of HL-related structural adaptations. Objectives: Comparing the thickness and cross-sectional area (CSA) of flexor hallucis brevis (FHB), flexor digitorum brevis (FDB), abductor hallucis (AbH), and quadratus plantae (QP) muscles, as well as the thickness of the plantar fascia (PF), Achilles tendon (AT), and plantar calcaneal fat pad (CFP), between participants with and without HL. Methods: Case–control study included 80 basketball players recruited from semi-professional teams by consecutive non-probabilistic sampling. Participants were divided into two groups: an HL group (n = 40) and a healthy group (n = 40). Musculotendinous parameters were assessed using RUSI. Results: The FDB, FHB, AB, and QP showed significant reductions in thickness and CSA at rest and at contraction in the HL group. PF thickness increased in participants with HL, while CFP thickness decreased significantly. Significance was established at (p < 0.05). Conclusions: HL participants exhibited reduced muscle size and CSA, increased PF, and lower CFP thicknesses, indicating adaptive tissue alterations.

Background: Metatarsus adductus is a relatively common congenital foot deformity often unrecognized at birth. There is adduction of the metatarsals, supination of the subtalar joint, and plantar flexion of the first ray. Objective: The objective of this study was to utilize the most commonly used methods for assessing metatarsus adductus deformity in children and to identify the measurements with the least intra- and inter-observer variability. Materials and methods: All consecutive patients between 2 and 9 years of age with metatarsus adductus by roentgenographic evaluation on weight-bearing dorsoplantar images were included in this cross-sectional study. Measurements included 32 radiographs, 18 feet from 14 girls with a mean age of 3.73 ± 2.53 years, and 14 feet corresponding to 11 boys with a mean age of 5.21 ± 2.15 years. We identified and assessed all radiographic measurements to evaluate the metatarsus adductus with the different measurements commonly used today, including the Berg, Kilmartin, Laaveg & Ponseti, rearfoot, Root, and Simons’ angles. Results: The reliability of the variables measured in 32 weight-bearing dorsoplantar foot radiographs showed excellent reliability ranging in Laaveg-Ponseti and rearfoot angles with low standard error of measurement (SEM), coefficient of variation (CV), and minimum detectable change (MDC) with intraclass correlation coefficient (ICC) higher than 0.990. Kilmartin, Root, and Simons’ angles showed good intra- and inter-observer reliability, with ICC values greater than 0.900; however, they also exhibited systematic differences between sessions or between observers (P < 0.05), or a high MDC value, which may limit their reproducibility. Conclusion: Based on the results obtained in this study from the different measurements performed, the rearfoot measurement and the method proposed by Laaveg and Ponseti can be considered the most reliable, as they showed the highest intra- and inter-observer reliability. Graphical

The infection caused by the COVID-19 virus, with its high capacity for spread and transmission, reached the level of an international pandemic, affecting many people and resulting in a large number of deaths. To analyse the experiences of nursing professionals caring for patients with COVID-19 during the early stages of the pandemic and the skills or coping strategies that they employed. A qualitative study was carried out with an interpretative phenological design. Semistructured interviews were conducted with 20 nursing professionals working in emergency and critical care units, which were adapted to care for patients with symptoms of the disease, in public hospitals in Madrid, Spain. The data were analysed following, the Interpretive Phenomenological Analysis (IPA) of Smith et al. Five themes were identified: “emotional brain training (EBT) to cope with great emotional stress”, “material and sequential difficulties”; “an experience similar to a war that can cause burnout”; “Second Victim Syndrome (SVS), the emotional impact of witnessing trauma”; and “Surviving COVID-19 with overloads of energy and positivity”. Nursing professionals who cared for patients with Covid-19 during the first wave of the pandemic lived an experience in which they experienced a brain training of feelings, including sadness, impotence, fear, anger, pain and much worry. They also experienced a great feeling of suffering and guilt as in Second Victim Syndrome, in a situation similar to a war, due to the number of deaths caused by the virus, with all this resulting in a great overload of work. It is essential that these situations do not affect the mental health of these professionals in the dimensions that they did, and it is necessary to regain enthusiasm and motivation to provide comprehensive care for patients with COVID-19. Nursing professionals are not alone and need to be taken care of to respond to the chaos that can cause a pandemic, without ignoring the risks that it entails. They require specific training, which is necessary to provide them with proper security, and it is necessary to develop health and welfare policies, which will not be possible without first understanding their experiences.

Background: Ankle sprain is the most common traumatic injury among handball players, which usually leads to the development of Chronic Ankle Instability (CAI). There is much evidence regarding the mechanical component about this condition; however, the psychological component has been little studied in previous research. The aim of this study was to compare anxiety, personality traits, depression, and kinesiophobia between young handball players with and without CAI. Methods: Case-control study. A sample of 100 young handball players was recruited and divided into athletes with CAI (case group, n = 50) and healthy athletes (control group, n = 50). Main outcome measures were anxiety, personality traits, depression and kinesiophobia levels, which were assessed by self-reported questionnaires (State-Trait Anxiety Inventory, Eysenck Personality Questionnaire, Beck Depression Inventory-II and Tampa Scale for Kinesiophobia-11). Results: Statistically significant differences were found between groups for anxiety, personality traits, depression and kinesiophobia. Case group showed higher levels of state anxiety (Δ-2.50; p < .05), trait-anxiety (Δ-3.80; p < .05), neuroticism (Δ-0.92; p < .05), depression (Δ-4.10; p < .05), and kinesiophobia (Δ6.82; p < .05) compared to the control group. Conclusions: Young handball players with CAI present significant greater levels of anxiety, neuroticism, depression and kinesiophobia compared to healthy young handball players.

El presente editorial tiene como objetivo detallar la influencia de diferentes metodologías educativas existentes con respecto al estado académico y psicológico de los estudiantes de enfermería durante el aprendizaje universitario. Se describieron diferentes metodologías de aprendizaje de enfermería en diversas universidades. Estas metodologías incluyeron aprendizaje presencial y en línea, aprendizaje basado en problemas, realidad virtual, aprendizaje transformador, simulación clínica, aula invertida y otras modalidades de enseñanza novedosas ( ¹ - ² ).

Este editorial tem como objetivo detalhar a influência de diferentes metodologias de educação existentes em relação ao estado acadêmico e psicológico dos estudantes de enfermagem durante a graduação. Diferentes metodologias de aprendizagem de enfermagem foram descritas em várias universidades. Essas metodologias incluem aprendizagem presencial e online, aprendizagem baseada em problemas, realidade virtual, aprendizagem transformadora, simulação clínica, sala de aula invertida e outras modalidades de ensino originais ( ¹ - ² ).