Jose Vicente Toledo-Marhuenda

Conservative treatment based on physiotherapy is the first option for non-tears rotator cuff related shoulder pain (RCSP). Although several studies demonstrate the positive effect of therapeutic exercise, aspects such as the influence of supervised exercises versus home-self training or the level of adherence are still unclear. The objective is to study the effect of home exercise programs compared to supervised exercise, either alone or combined with standard physiotherapy treatment. Web of Science, PubMed, SCOPUS, EMBASE, trials registries and reference lists with relevant articles were searched up to March 2025. Only randomized controlled trials were included that aimed to compare the effect of a home exercise program in patients versus supervised exercise, either in isolation or with usual physiotherapy. The PEDro scale and the Cochrane Collaboration tool were used to evaluate the quality of the studies and the risk of bias, respectively. Exercise Interventions Content Assessment, using the proforma provided in the CERT, and adherence were extracted from the included manuscripts. Data were extracted by two independent assessors using a standardized form. Meta-analyses were conducted with the R statistical program using fixed or random effects models according to the heterogeneity assessed with I² coefficient. Twelve RCTs (N.=475) were included. Home self-training was similar and no differences were found at 12 weeks from supervised exercise program, either alone or combined with standard physiotherapy treatment on Visual Analogic Scale (VAS) (SMD, 0.92; 95% CI, 0.58 to 1.26, P=0.66); Constant-Murley Score (CS) (SMD, -0.82; 95% CI, -1.05 to -0-60, P=0.64); and Shoulder Pain and Disability Index (SPADI) (SMD, 1; 95% CI, 0.74 to 1.26, P=0.93). It was impossible to include adherence in the meta-analysis due to the small number of studies reporting this data and the heterogeneity of the criteria for accepting adequate adherence to the prescribed exercise program. Home self-training might be equally effective as outpatient and supervised exercise, isolated or combined with the usual physiotherapy, in terms of primary outcomes. However, the lack of information on adherence rates, the content of the exercise or how it is performed is worrying. Furthermore, the heterogeneity of the criteria related to treatment adherence and compliance indicates that more literature is needed to relate the effect produced with the type of exercise and therapeutic adherence.

Whiplash injuries (WLs) are the most frequent cause of emergency room visits after motor vehicle collisions. In clinical practice, massage, electrotherapy, mobilization, or therapeutic exercise are used. As part of manual therapy, high-velocity, low-amplitude manipulative techniques can also be used. Objectives: To evaluate the effect of the cervical Specific Adjustment Technique (SAT) in adults affected by whiplash on pain, functionality, cervical mobility, and radiological changes in cervical curvature through a prospective, single-blind, randomized clinical trial. Methods: One hundred and nineteen patients with grade II acute WL were randomly assigned to either the manipulation group (MAN group = 59) or the rehabilitation group (RHB group = 60) to receive 3 or 20 sessions of treatment, respectively. Both groups were measured at baseline and 15, 30, and 120 days after starting treatment. Results: Statistically significant differences were found in the MAN group in flexion (p = 0.041) and left-side bending (p = 0.022); similar statistical values were found in the other measures. According to the interaction treatment-time effect, statistical significance for the Cobb angle was obtained in the MAN group (p = 0.047). Conclusions: the effects of SAT were comparable in terms of pain, functionality, and mobility of the cervical spine. Although further research is needed on its effects in the acute phase, due to its effectiveness and lower associated cost, SAT could be considered a useful technique, at least during the first 3 months after a traffic collision.

To assess the effects of the eFisioTrack monitoring system on clinical variables in patients with prescribed physiotherapy for shoulder injuries, twenty-four adult patients with shoulder orthopaedic injuries who underwent physical therapy treatment in a hospital setting participated in the study (twelve in the experimental group and twelve as controls). Clinical outcome measures were shoulder function and pain (Constant–Murley Score and Disabilities of the Arm, Shoulder, and Hand or DASH score). Each variable was measured by a blinded physiotherapist at baseline and at one month follow-up. Patients performed the prescribed exercises either supervised by the physiotherapist (control group) or in a separate room without therapist supervision (experimental group). There were no statistically significant differences between groups before treatment or at follow-up for any outcomes (p ≥ 0.05). There was a statistically significant decrease (p ≤ 0.05) of at least 10 points in both groups for the DASH score at follow-up. Differences in the total score and subjective components of the Constant–Murley were also evidenced within groups. The use of the eFisioTrack system showed similar results in clinical measures compared to those performed under the direct supervision of the physiotherapist. This approach might be suitable for providing an effective shoulder exercise program at home.

Objectives: To assess the short-term impact of a single global stretching session on plantar pressures and lumbar range of motion (RoM) over one week in sedentary university students. Design: A randomised controlled trial with two parallel groups. Participants: Sixty-four university students were randomly assigned to a stretching group or control group. The stretching group received a single session of global stretching and the control group remained seated for the same length of time as the stretching session. Main outcome measures: Lumbar RoM and plantar pressures were assessed before, immediately after, 48 hours after, and 7 days after intervention. Results: Group-by-time interaction was significant for lumbar lateral flexion (p = 0.044), right maximal pressure (p = 0.003), left maximal pressure (p = 0.008), right mean pressure (p = 0.025), left mean pressure (p = 0.002), and maximal pressure minus mean pressure in right foot (p = 0.007). The model with plantar pressures showed a significant difference for group-by-time interaction (p = 0.010).Conclusion: Global stretching seems to counteract the ill-effects of prolonged sitting up to seven days with respect to plantar pressure in standing without improving lumbar ROM

Una de estas estrategias diferentes a la metodología clásica de enseñanza es el conocido como proceso de coevaluación entre alumnos, lo que permite un sistema de retroalimentación derivado de la evaluación entre iguales. Este sistema se constituye como un complemento perfecto a las clases prácticas tradicionales de fisioterapia. En este trabajo, después de plantear la organización de esta metodología como una simulación del examen práctico de laboratorio, se analizan los resultados derivados de la coevaluación y autoevaluación de los alumnos para, posteriormente, poder comparar los resultados con los derivados de la evaluación del profesor. Finalmente, se discuten las ventajas y desventajas que esta metodología presenta en relación a la anterior y tradicional forma de trabajo. One of these strategies different from the classic methodology of teaching is known as peer assessment process, including students, laboratory practices physical therapy, allowing a feedback system derived from the peer evaluation. This system is a perfect complement to the traditional practice of physical therapy classes. In this paper, after fully discussing the organization of this methodology as a practical exam simulation laboratory, analyze the results from the co-evaluation and self-evaluation of the students to then be able to compare the results with those derived from teacher assessment. Finally, we discuss the advantages and disadvantages of the methodology presented in relation to the previous and traditional way of working. Resumen Tema de interés: Actividades para el desarrollo de trabajo en grupos, seguimiento del aprendizaje colaborativo y experiencias en tutorías. Objetivos: Exponer la metodología de un sistema de coevaluación y autoevaluación de prácticas de laboratorio a los alumnos de Fisioterapia como recurso innovación docente. Conocer, a priori, los criterios que según los alumnos deben ser establecidos para la calificación del examen y compararlos con aquellos identificados por los profesores participantes como paso previo al establecimiento de los mismos por consenso, considerado justo y que sea capaz de reflejar de forma adecuada el grado de conocimiento real mostrado

Background: Few previous studies have analyzed the effects of certain specific static and dynamic warm-up components on recreational sports players with a previous hamstring injury. Therefore, the aim of this study was to analyze changes in some modifiable and external risk factors after (immediately and in a follow-up assessment after 10 min) a static or dynamic warm-up program on recreational sports players with a previous hamstring injury. Methods: A total of 62 participants were randomized into 2 groups: static warm-up (SW) (n = 31) or dynamic warm-up (DW) (n = 31). Range of movement (RoM), perceived pain, the pressure–pain threshold, and joint position sense were assessed at baseline, immediately after the intervention and 10 min afterwards. The intervention for the SW (hot pack procedures in both hamstring muscles) lasted 20 min. The DW intervention consisted of a running exercise performed on a treadmill for 10 min. Results: Both groups showed statistically significant changes (p ≤ 0.05) in the primary outcomes (perceived pain and the pressure–pain threshold) at the three measurement times (this was also true for RoM for the SW group, with statistically significant differences only between times from the baseline to the 10-min follow-up; p ≤ 0.05, d = 0.23). The intra-group secondary outcome showed no statistically significant changes (p > 0.05) in both groups (except for the period from the baseline–immediately after in the DW group; p ≤ 0.05, d = 0.53). The comparison between groups showed no statistically significant differences for any of the variables analyzed. (p ≥ 0.05). Conclusion: The present findings suggest that both specific warm-up modalities seem to positively influence perceived pain on stretching and the pressure threshold; however, the significant reduction in the joint repositioning error and the larger effect sizes observed in the DW group suggest that this method has a greater beneficial impact in recreational sports players with clinical histories of hamstring injuries.

Chronic pain is a significant and costly problem all over the world that negatively impacts the quality of life of sufferers. There are clear discrepancies between the prevalence of chronic pain in society and the low priority assigned to educating future physicians about the complexities of pain. This condition also occurs in other undergraduate health science students, although research in this area has not been studied as much as in medical schools. Based on the International Association for the Study of Pain (IASP) Pain Curriculum Outline, a systematic search of the available literature, and the authors’ own experiences, we highlight some relevant tips to educate health science trainees in the management of patients with chronic pain. These tips highlight current international recommendations for a comprehensive approach to this prevalent problem in society, which should be learnt during the university training of health professionals.