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Parkinson’s disease is a common neurodegenerative disease and it is known to cause motor disturbances associated with musculoskeletal problems of the locomotor apparatus, and non-motor symptoms, that are believed to have a harmful effect on health, social functioning and mobility. The aim of this study was to evaluate depression in patients with Parkinson’s Disease (PD) compared to subjects who do not have it. The sample consisted of 124 participants (mean age 69.18 ± 9.12). Patients with PD were recruited from a center of excellence for Parkinson’s disease (cases n = 62) and healthy subjects without PD from their relatives and caregivers (control n = 62). The Spanish version of Beck’s Depression Inventory (BDI) scores and categories were collected. A clear statistically significant difference (p &lt, 0.05) was evident in the BDI scores between both groups. Parkinson’s patients presented worse results on the BDI = 15.48 ± 7.24 points compared to healthy subjects with BDI = 7.03 ± 6.99 points. Regarding BDI categories, there were statistically significant differences (p &lt, 0.001) for the greater BDI categories in the Parkinson’s group compared with healthy subjects. The depression represents an important potential risk for increased symptoms and negative impact among patients with PD compared with healthy subjects.

Background: the aim of this study was to compare the echotexture of patients with soleus muscle injury and age matched controls. Methods: a sample of 62 athletes was recruited at the private clinic and was divided in two group: a healthy group (n=31) and a soleus pathology group whose athletes had soleus muscle injury, located in the central tendon (n=31). The muscle thickness (MTh), echointensity (EI) and echovariation (EV) were analyzed. An intra-rater reliability test (Intraclass Correlation Coefficient-ICC) was performed in order to analyze the reliability of the values of the measurements. Results: Sociodemographic variables did not show statistically significant differences (p &gt, 05). Ultrasound imaging measurements who reported statistically significant differences were EI (p = .001) and standard deviation (SD) (p = 0.001). MTh and EV variables did not show statistically significant differences (p = .381 and p = .364, respectively). Moreover, reliability values for the MTh (ICC = .911), EI (ICC = .982), SD (ICC = .955) and EV (ICC = .963). Based on these results the intra-rater reliability was considered excellent. Conclusion: Athletes with a central tendon injury of soleus muscle showed a lower EI when they were compared to healthy athletes. The echogenicity showed by the quantitative ultrasound imaging measurement may be a more objective parameter for the diagnosis and follow-up the soleus muscle injuries.

Tailor&rsquo, s bunion (TB) disease should be considered one of the foot injuries that causes disability in feet as well as general health. This case&ndash, control descriptive study investigated and contrasted the effects of different TB types in a sociodemographic population using the Foot Health Status Questionnaire (FHSQ). A sample of 100 subjects with a mean age of 51.70 &plusmn, 17.78 years was recruited and requested to reply to a foot health survey. Results were self-reported. Subjects were scored. Participants with TB type III (TB3) registered lower scores for foot pain, foot function, footwear, and foot health. Physical activity and social capacity had higher scores, and vigor and general health were lower. A Kruskal&ndash, Wallis test was used for systematic differences between the FHSQ and different TB types. In all analyses, statistical significance was considered a p-value &lt, 0.05 with a 95% confidence interval. Statistically significant differences were found between all domains of the FHSQ and TB, except for the social capacity domain and vigor. The FHSQ is an important measurement tool in TB subjects, showing that factors such as sex, age, and footwear used throughout an individual&rsquo, s life are significantly associated with the development of TB3 and its influence on foot pain and foot health.

Muscle damage induced by exercise may have several consequences such as delayed-onset muscle soreness, a side-effect of the release of free radicals during oxidative stress. To mitigate the oxidative stress cascade, the oral intake of antioxidants has been assessed by several research groups. This review examines whether supplementation with vitamin C and/or vitamin E is able to prevent or attenuate delayed-onset muscle soreness after eccentric exercise. The PubMed, Web of Science, Medline, and Embase databases were searched to identify studies meeting the inclusion criteria: primary randomized control trials, healthy male and female participants aged 16–80 years, and an intervention consisting of the intake of vitamin C and/or vitamin E without other supplements plus a controlled eccentric exercise regimen. Further requirements were the measurement of muscle soreness or markers of delayed-onset muscle soreness. All original full-text articles in English or translated into English published from January 2000 to June 2020 were considered for this review. Fourteen studies were finally identified, including 280 participants, 230 men, and 50 women aged 16–30 years. All participants were healthy individuals with different starting levels of physical activity. Supplementation was acute in two studies and chronic in 12, and its consisted of vitamin C in eight studies, vitamin E in two studies, and both in four studies. Only in 3 of the 14 studies was muscle soreness found to be significantly reduced in response to vitamin C and/or vitamin E supplementation at all time points when compared to the placebo group. Despite some studies showing the beneficial effects of chronic supplementation with these vitamins on muscle soreness manifesting 24–72 h after eccentric exercise, the evidence is so far insufficient to confirm that the intake of antioxidant vitamins is able to minimize delayed-onset muscle soreness in this context. Sin financiación 7.675 Q1 JCR 2021 1.008 Q1 SJR 2021 No data IDR 2021 UEM

[Abstract] The Italian Self care diabetic foot questionnaire, (SDFQ-IT) is considered a dia-betic foot self-care evaluation tool with 16 questions for assessing diabetic foothealth disorders. To date, SDFQ has been validated in different languages, butan Italian version was lacking. Consequently, the purpose of this study was totranslate and validate the Italian version of the SDFQ-I T (SDFQ-IT). A suitablemethod was developed for the translation protocol and cross-cultural valida-tion from Spanish to Italian. Regarding the total marks from each sub-scale,agreement degrees, and confidence were analysed using the Cronbach's α andintraclass correlation coefficient (IC C), respectively. In addition, the mean± SD differences between pre and post-tests were calculated and completedusing the Bland and Altman distribution plots. Excellent agreement betweenthe two versions based on Cronbach's α was demonstrated. Three sub-scalesconsisting of knowledge of foot hygiene, the appropriate use of footwear andsocks, and podiatric self-care were added together to obtain the total score.Excellent retest reliability was shown for the total score. Test/retest reliabilitywas excellent for the self-care domain, and shock and shoe sub-scales. Therewere no significant differences among any domain (P > .05). There were nostatistically significant differences (P = .000) for the mean ± SDs differencesbetween pre-and post-tests (92.9200 ± 12.914) [89.25-96.59] and 92.9200± 13.012 [89.22-96.62] points, respectively). Bland and Altman plots or clini-cally pertinent variations were not statistically significantly different. TheSDFQ-IT is considered a strong and valid questionnaire with adequate repeat-ability in the Italian community. This research was funded by Generalitat Valenciana, grant number GV/2020/061 and the APC was funded by Universitat de València Generalitat Valenciana; GV/2020/061

[Abstract] Reduced plantar foot sensation, postural instability, and gait difficulties are characteristic of Parkinson´s disease patients. A systematic review was carried out to determine the effect of the different types of insoles and shoes in these patients. Several databases were used to search for relevant articles reporting Parkinson´s disease patients undergoing treatment with any type of insole and footwear. All titles and abstracts were reviewed independently by two reviewers and the available data were extracted. The study eligibility criteria were any type of experimental study that included Parkinson’s disease patients treated with any type of insole or footwear. Eight studies were selected. Interventions used were textured insoles, footwear modifications, and habitual footwear. Three different outcomes were evaluated in each study: gait parameters, balance, and plantar sensation. According to the data available from this systematic review, the most important conclusion is that more controlled studies are needed in this research field. There are indications to suggest that textured insoles have positive effects on gait parameters, balance, and plantar sensation in Parkinson’s disease patients. This research was funded by the Generalitat Valenciana, grant number GV/2020/061 Generalitat Valenciana; GV/2020/061

Foot problems are highly prevalent conditions, being a frequent reason for medical and podiatric consultation. The aim of this study was to compare the differences of quality of life (QoL) related to foot health in people with and without the presence of foot problems. A case–control study was carried out in an outpatient centre, where a clinician recorded data related to sociodemographic and clinical characteristics. In addition, self-reported data on foot health-related quality of life were recorded using the Spanish version of the Foot Health Status Questionnaire. The sample consisted of 498 participants (249 cases and 249 controls), with a median age of 30 years and an interquartile range of 23 years. The differences between the groups were statistically significant for gender, age, footwear, general health, foot health, and physical activity. Cases showed lower scores for the domain of footwear, physical activity and vitality compared to controls. Foot pathologies have a negative impact on quality of life related to foot health, and the domains of footwear, general health and physical activity seem to be the factors that are associated with the presence of alterations and foot deformities.

[Abstract] BACKGROUND: Frailty is a condition that can increase the risk of falls. In addition, foot disorders can negatively influence elderly people, thus affecting their condition of frailty. OBJECTIVE: To determine whether foot pain can influence a greater degree of frailty. DESIGN AND SETTING: Cross-sectional descriptive study conducted at the University of Valencia, Valencia, Spain. METHODS: A sample older than 60 years (n = 52), including 26 healthy subjects and 26 foot pain patients, was recruited. Frailty disability was measured using the 5-Frailty scale and the Edmonton Frailty scale (EFS). RESULTS: There were statistically significant differences in the total EFS score and in most of its subscales, according to the Mann-Whitney U test (P < 0.05). In addition, foot pain patients presented worse scores (higher 5-Frailty scores) than did healthy patients, regarding matched-paired subjects (lower EFS scores). With regard to the rest of the measurements, there were no statistically significant differences (P > 0.05). The highest scores (P < 0.001) were for fatigue on the 5-Frailty scale and the EFS, and for the subscale of independence function in EFS. CONCLUSIONS: These elderly patients presented impairment relating to ambulation and total 5-Frailty score, which seemed to be linked to the presence of frailty syndrome and foot disorders. This research was funded by Generalitat Valenciana, under grant number GV/2020/061 Generalitat Valenciana; GV/2020/061

Objective: M-mode ultrasound imaging (US) reflects the motion of connective tissue within muscles. The objectives of this study were to evaluate inter-rater and intra-rater reliability of soleus muscle measurements between examiners with different levels of US experience in asymptomatic subjects and to investigate the level of soleus muscle isometric activity in two positions (knee extended and knee flexed at 30&deg, ). Methods: Thirty volunteers without a history of ankle pain were evaluated with US examinations of the soleus muscle. Each muscle was scanned independently by two evaluators. Muscle at rest thickness, maximal isometric contraction thickness, time and velocity measures were detailed and blinded to the other examiner. Results: Intra- and inter-rater reliability at rest, in maximal isometric contraction thickness, contraction time and contraction velocity measures for both positions (extended and flexed knee) were reported from good to excellent for all outcome measurements. The position with the knee extended reported a statistically significant increase in thickness after motion showing 1.33 &plusmn, 0.27 mm for measurements at rest thickness with knee extended versus 1.50 &plusmn, 0.29 mm for measurements at end thickness with the knee in flexed position (p = 0.001), as well as 1.31 &plusmn, 0.23 mm for rest thickness with the knee in flexed position measurements with respect to 1.34 &plusmn, 0.24 mm for maximal isometric contraction thickness with extended knee measurements (p = 0.058). Conclusions: This study found that intra- and inter-examiner reliability of M-mode ultrasound imaging of the soleus muscle was excellent in asymptomatic subjects and the soleus muscle activity was different between the position with the knee extended and the position with the knee flexed.

Currently evidence-based practice has given scientific weight to the physical therapist profession; it is essential that all medical professional and physical therapists know the usefulness of new tools that optimize the effectiveness of their interventions and allow the growing of the scientific knowledge base. The use of ultrasound imaging (USI) by physiotherapists has evolved in recent years, consolidating as an increasingly standardized technique, low cost compared to other imaging techniques, quickly of execution, feasible and reliable tool. USI offers a wide range of opportunities in clinical practice as well as in different research areas. Therefore, ultrasound has been currently used as a diagnostic tool by physicians and in recent years there has been an expansion of the use of ultrasound equipment by non-physicians professionals such as physical therapist or physical trainers, who incorporates USI as a means of assessing musculoskeletal system architecture and composition, musculoskeletal changes in dysfunction, pain or injury conditions, as an interventional technique assisting echo-guided procedures or using the visual real-time information as a biofeedback in control motor approaches, as guiding tool in clinical decisions as well as to improve the understanding of tissue adaptations to exercise or movement. The purpose of this article is to review and provide an overview about the currently research of the USI applications and their benefits for the diagnosis and management in individuals with musculoskeletal conditions.

[Abstract] Background: Parkinson's disease (PD) is a common and complex neurological problem. Gait abnormalities are frequent in PD patients, and this increases the risk of falls. However, little is known about foot deformities and footwear in this vulnerable population. Here we investigate whether patients with PD use an appropriate shoe size and know if they have foot deformities or alterations. Methodology: A study of a series of observational descriptive cases in a convenience sample (n = 53 patients) diagnosed with Parkinson's disease. One trained investigator evaluated foot and ankle health. The footwear and foot measurements were obtained using a Brannock device. Results: The podiatric examination and footwear examination detected a high presence of podiatric pathologies and inappropriate footwear. This has a negative impact on the quality of life of these patients. Conclusions: This research detected an elevated number of people with foot deformities or alterations. Moreover, a high proportion of participants with PD wear inadequate footwear (in length, width, or both).

Background: The mobility of the first metatarsophalangeal joint (I MPTJ) has been related to the proper windlass mechanism and the triceps surae during the heel-off phase of running gait, the orthopedic treatment of the I MPTJ restriction has been made with typical Morton extension orthoses (TMEO). Nowadays it is unclear what effects TMEO or the novel inverted rocker orthoses (NIRO) have on the EMG activity of triceps surae during running. Objective: To compare the TMEO effects versus NIRO on EMG triceps surae on medialis and lateralis gastrocnemius activity during running. Study design: A cross-sectional pilot study. Methods: 21 healthy, recreational runners were enrolled in the present research (mean age 31.41 &plusmn, 4.33) to run on a treadmill at 9 km/h using aleatory NIRO of 6 mm, NIRO of 8 mm, TMEO of 6 mm, TMEO of 8 mm, and sports shoes only (SO), while the muscular EMG of medial and lateral gastrocnemius activity during 30 s was recorded. Statistical intraclass correlation coefficient (ICC) to test reliability was calculated and the Wilcoxon test of all five different situations were tested. Results: The reliability of values was almost perfect. Data showed that the gastrocnemius lateralis increased its EMG activity between SO vs. NIRO-8 mm (22.27 &plusmn, 2.51 vs. 25.96 &plusmn, 4.68 mV, p &lt, 0.05) and SO vs. TMEO-6mm (22.27 &plusmn, 2.51 vs. 24.72 &plusmn, 5.08 mV, p &lt, 0.05). Regarding gastrocnemius medialis, values showed an EMG notable increase in activity between SO vs. NIRO-6mm (22.93 &plusmn, 2.1 vs. 26.44 &plusmn, 3.63, p &lt, 0.001), vs. NIRO-8mm (28.89 &plusmn, 3.6, p &lt, 0.001), and vs. TMEO-6mm (25.12 &plusmn, 3.51, p &lt, 0.05). Conclusions: Both TMEO and NIRO have shown an increased EMG of the lateralis and medialis gastrocnemius muscles activity during a full running cycle gait. Clinicians should take into account the present evidence when they want to treat I MTPJ restriction with orthoses, and consider the inherent triceps surae muscular cost relative to running economy.

BACKGROUND Home blood pressure monitoring has many benefits, even more so, in populations prone to high blood pressure, such as persons with diabetes. OBJECTIVE The purpose of this research was to validate the QardioArm mobile device in a sample of individuals with noninsulin-dependent type 2 diabetes in accordance with the guidelines of the second International Protocol of the European Society of Hypertension. METHODS The sample consisted of 33 patients with type 2 diabetes. To evaluate the validity of QardioArm by comparing its data with that obtained with a digital sphygmomanometer (Omron M3 Intellisense), two nurses collected diastolic blood pressure, systolic blood pressure, and heart rate with both devices. RESULTS The analysis indicated that the test device QardioArm met all the validation requirements using a sample population with type 2 diabetes. CONCLUSIONS This paper reports the first validation of QardioArm in a population of individuals with noninsulin-dependent type 2 diabetes. QardioArm for home monitoring of blood pressure and heart rate met the requirements of the second International Protocol of the European Society of Hypertension.

Background and Objectives: Flexor hallucis longus pathology is one of the most common conditions of the ankle and foot in dancers, due to the high demand of dance movements performed in an extreme plantar flexion and dorsiflexion range of motion. The objectives of this study were to determine the bilateral differences between the thickness and cross-sectional area of the flexor hallucis longus muscle in dancers, to establish possible differences between dance modalities, and to analyze whether there is a correlation between ultrasonographic parameters or performance variables and the dance modality. Material and Methods: A sample of 50 (29 classical and 21 contemporary) full-time pre-professional female dancers were included in the study. The thickness and cross-sectional area of the flexor hallucis longus muscle were evaluated for both limbs using ultrasound imaging. The range of movement of the first metatarsophalangeal joint was measured using functional extension with maximal ankle plantarflexion, balance was measured in a unilateral stance with the heel raised, endurance was evaluated through a modified heel rise fatigue test, and a counter movement jump to assess the vertical jump performance was measured bilaterally. Results: There were no significant differences recorded between the dominant and non-dominant limbs for each variable, within both groups. Contemporary dancers showed a greater thickness and cross-sectional area of the flexor hallucis longus muscle than classical dancers. However, classical dancers showed an increase of balance, endurance, range of movement of the first metatarsophalangeal joint, and counter movement jump with respect to contemporary dancers. Conclusion: Bilateral symmetry was identified in all variables for both groups. The size and performance of the flexor hallucis longus muscle may be influenced by the specific nature of dance modality. Sin financiación 2.430 JCR (2020) Q2, 80/169 Medicine, General & Internal 0.530 SJR (2020) Q3, 1256/2448 Medicine (miscellaneous) No data IDR 2019 UEM

Subungual osteochondroma (SO) is an infrequent and non-malignant bone tumour of the distal phalanx, especially prominent in paediatric populations. The aim of this research was to describe a case series of paediatric feet with SO which received surgical treatments. The secondary purpose was to compare these descriptive data by sex distribution. Methods: Twenty-three paediatric feet with SO confirmed by clinical or radiological features received surgical treatment. Socio-demographic (age, sex, height, weight and BMI) and clinical features (side, location, tumour or pain presence, and nail lift before surgery, as well as recurrence and adverse effects at one month after intervention) were reported. Results: Regarding clinical features before intervention, the most frequent locations of SO were the first toe (86.8%) and the right lower limb (56.5%). In addition, the presence of the tumour, pain and nail lift showed a prevalence of 91.3%, 69.5% and 47% of the study sample, respectively. Considering clinical features at one month after intervention, the most frequent adverse effect was the pain presence (69.5%). In addition, one case (4.4%) presented ulceration. Only one patient (4.4%) suffered from recurrence with a new tumour. There were not statistically significant differences by sex distribution (p &gt, 0.05). Conclusions: This novel study showed that surgery treatment for SO in paediatric populations presented a very low recurrence degree with minor adverse effects and without differences by sex distribution. Thus, further randomized clinical trials should be carried out in order to determine the effectiveness of this intervention in this special population.

Background: Primary dysmenorrhea (PD) is one of the most common gynecological disorders in women of reproductive age that may affect quality of life. It is believed that the underlying cause of PD may be the excessive production of prostaglandins (PGs), however, between 20%-25% of women with PD did not respond to pharmacological treatments, showing that nociceptive mechanisms underlying PD are still not understood. The purpose of this study was to measure and compare, through the use of ultrasound imaging, the thickness at rest of the abdominal wall, as well as the interrecti distance (IRD), in women with and without PD. Methods: A cross-sectional study has been performed using ultrasound imaging (USI) to measure the resting thickness of the external oblique (EO), internal oblique (IO), transversus abdominis (TrAb), rectus abdominis (RA), as well as the IRD in a sample of 39 women, 19 with PD and 20 without PD (median ± IR age: 20 ± 4 and 22.5 ± 7 years, respectively). Results: Findings of muscular thickness did not reveal statically significant differences (p < 0.05) in EO, IO, TrAb, RA, and the IRD between the PD group and control group. Conclusions: These findings suggest that the thickness of the abdominal wall is not associated with PD. Sin financiación 3.706 JCR (2020) Q2, 45/169 Medicine, General & Internal 0.622 SJR (2020) Q3, 70/121 Clinical Biochemistry No data IDR 2019 UEM

A growing number of research papers regarding Spanish-speaking dancers justifies the need for an adapted Spanish version of the Dance Functional Outcome Survey (DFOS). The objective of this study was to cross-culturally adapt and validate the DFOS for Spanish-speaking dancers. A sample of 127 healthy and injured professional and pre-professional dancers were recruited. Test-retest reliability of DFOS-Sp was examined using intraclass correlation coefficients. Construct validity compared DFOS-Sp to the Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36) using Pearson correlations. Principal component analysis identified factors and internal-item consistency. Sensitivity was evaluated by generating receiver operating characteristic and area under the curve analyses. A subgroup of 51 injured dancers were followed across three time-points to examine responsiveness using repeated measures analysis of variance. Injured scores were analyzed for floor and ceiling effects. The DFOS-Sp showed high test-retest reliability (ICC2,1 &ge, 0.92). DFOS-Sp scores had moderate construct validity compared with SF-36 physical component summary scores (r &ge, 0.56). Principal component analysis (PCA) supported uni-dimensionality explaining 58% of the variance with high internal consistency (&alpha, = 0.91).Area under the curve (AUC) sensitivity values were excellent (AUC &ge, 0.82). There were significant differences across time (p &lt, 0.001), demonstrating responsiveness to change, with no floor or ceiling effects. The DFOS-Sp demonstrated acceptable test-retest reliability and validity in Spanish-speaking dancers, with comparable psychometric performance to the English-language version.

Nowadays, the use of insoles in sport practice have been recognized to decrease the foot and lower limb injury patterns. The aim of this study was to analyse the effect of four types of hardness insoles (HI) in the activity patterns of the hip and thigh muscles (HTM) in motoriders during motorcycling sport. The study was a crossover trial. Subjects were elite motoriders. The mean age was 33 &plusmn, 5.14 years. Electromyography (EMG) of hip and thigh muscles (HTM) data was registered via surface while subjects were riding on an elite motorcycle simulator. Subjects had to complete different tests with randomly hardest insoles (HI): 1: only polypropylene (58&deg, D Shore), 2: Polypropylene (58&deg, D Shore) with selective aluminium in hallux and metatarsal heads (60 HB Brinell hardness), 3: Ethylene vinyl acetate (EVA) (52&deg, A Shore), and finally, 4: Ordinary EVA (25&deg, A Shore) as the control. EMG patterns of the HTM, riding on an elite motorcycle simulator, showed the lowest peak amplitude with the insoles with polypropylene and selective aluminium. Using the hardest insoles in our study (selective aluminium) the EMG amplitude peaks decreased in all HTM.

Objectives: To analyze the prevalence of tendon pathology and performance associated in pre-professional classic dancers with no history of Achilles tendon (AT) pain. Design: A cross-sectional study was conducted. Participants: Twenty-nine classic ballet dancers without AT pain (58 tendons) were recruited. The tendons were classified (normal, abnormal) using ultrasound imaging (USI). Cross-sectional area (CSA) and thickness of flexor hallucis longus (FHL) muscle were measured using USI. Range of movement (ROM) of the first metatarsophalangeal join, balance test, endurance test and vertical jump were measured (bilaterally) as performance variables. Results: More than a half (62%) of the participants had at least one abnormal tendon, with 45% of the dancers in the abnormal group having bilateral abnormalities. Dancers with AT pathology had significantly more years of dancing and number of weekly pointe hours than those with no pathology on US imaging. No significant differences between the groups were identified for the rest of the variables. Dancing years were moderately correlated with AT thickness. Conclusions: Asymptomatic classic dancers had a high incidence of tendon pathology. Increased dancing years was associated with pathology in the AT. Nevertheless, these abnormalities may not affect dance performance. Sin financiación 2.365 JCR (2020) Q2, 32/68 Rehabilitation 0.906 SJR (2020) Q1, 42/210 Physical Therapy, Sports Therapy and Rehabilitation No data IDR 2019 UEM

Background Home blood pressure monitoring has many benefits, even more so, in populations prone to high blood pressure, such as persons with diabetes. Objective The purpose of this research was to validate the QardioArm mobile device in a sample of individuals with noninsulin-dependent type 2 diabetes in accordance with the guidelines of the second International Protocol of the European Society of Hypertension. Methods The sample consisted of 33 patients with type 2 diabetes. To evaluate the validity of QardioArm by comparing its data with that obtained with a digital sphygmomanometer (Omron M3 Intellisense), two nurses collected diastolic blood pressure, systolic blood pressure, and heart rate with both devices. Results The analysis indicated that the test device QardioArm met all the validation requirements using a sample population with type 2 diabetes. Conclusions This paper reports the first validation of QardioArm in a population of individuals with noninsulin-dependent type 2 diabetes. QardioArm for home monitoring of blood pressure and heart rate met the requirements of the second International Protocol of the European Society of Hypertension.

Background: The triceps surae muscle has been identified with propulsion during running gait, and typical heel-lift orthotics (THOs) have been used to treat some sports injuries of this structural-biomechanical unit. The effects of a novel propulsion heel-lift orthotic (PHO) on surface electromyography (EMG) activity of the gastrocnemius during a full cycle of running have yet to be tested. Purpose/Hypothesis: We aimed to assess EMG changes in gastrocnemius medialis and lateralis muscle activity when wearing THOs, PHOs, or neutral sports shoes only (SO) during running. We hypothesized that EMG activity of the triceps surae muscle would be lower for PHOs than THOs or SO during running. Study Design: Controlled laboratory study. Methods: A total of 26 healthy, regular recreational runners of both sexes (mean age, 33.58 ± 6.02 years) with a neutral Foot Posture Index and rearfoot strike pattern were recruited to run on a treadmill at 9 km/h using aleatory THOs of 6 and 9 mm, PHOs, and SO while EMG activity of the gastrocnemius medialis and lateralis muscles was recorded over a 30-second period. Intraclass correlation coefficients were calculated to assess reliability. Results: The intraclass correlation coefficient values indicated near perfect reliability, ranging from 0.801 for 6-mm THOs to 0.959 for SO in the gastrocnemius lateralis muscle. EMG activity of the gastrocnemius lateralis muscle was greater for PHOs (25.516 ± 4.780 mV) than for SO (23.140 ± 4.150 mV) ( P < .05), but EMG activity of the gastrocnemius medialis muscle did not show any statistically significant difference between conditions (23.130 ± 2.980 mV vs 26.315 ± 2.930 mV, respectively) ( P = .3). Conclusion: A novel PHO may increase muscle activity of the gastrocnemius lateralis during a full cycle of running gait; consequently, its prescription to treat triceps surae muscle injuries is cautioned. Clinical Relevance: The prescription of novel PHOs could increase EMG activity, which has not been previously described.

New trends in ultrasound imaging are focused on exploration of morphology and muscle quality. The main goal of the study was to evaluate the first-order descriptor and echostructure of lumbar multifidus at the L4 vertebral level in athletes with and without chronic lumbopelvic pain (CLPP). A case-control study was performed in 15 semiprofessional athletes with CLPP and 15 without (healthy athletes). Lumbar multifidus echointensity and echovariation were measured for muscle quality assessment. Echostructure was used to evaluate lumbar multifidus cross-sectional area (CSA) at resting and during muscle contraction, respective differences during both phases (CSADif.), activation patterns, and thoracolumbar fasciae morphology and thickness. Significant differences with a large effect size were observed in quantitative data from CLPP and healthy athletes for left lumbar multifidus CSADif. and thoracolumbar fasciae morphology. Categorical data showed statistically significant differences with a small-to-moderate effect size for lumbar multifidus activation pattern and thoracolumbar fasciae morphology. Athletes with CLPP showed a reduced CSA difference between lumbar multifidus contraction and at resting and higher disorganization of thoracolumbar fasciae morphology compared to healthy athletes. These findings suggest the importance of dynamic exploration of the lumbar region and connective tissue in sports performance and injury prevention. Sin financiación 4.241 JCR (2020) Q1, 39/169 Medicine, General & Internal No data SJR 2020 No data IDR 2019 UEM

The objective of this study was to evaluate the short-term and crossover effects of a percutaneous neuromodulation (PNM) intervention on the femoral nerve, regarding the pain, knee flexion motion (range of motion (ROM)), and functionality, in patients with unilateral anterior knee pain (AKP). Our study used a randomized clinical trial design. Thirty patients were divided into two groups: one asymptomatic knee group in which patients received stimulation in the femoral nerve corresponding to the nonsymptomatic knee, and one symptomatic knee group, in which patients received stimulation in the femoral nerve corresponding to the painful knee. Pain, knee flexion ROM, Victorian Institute of Sport Assessment-Patella (VISA-P) and Kujala questionnaires were evaluated. Twenty-eight patients completed the study. Compared to their baseline values, both groups showed an increase immediately at 24 h, and at 1 week for the knee flexion ROM variable. In addition, the symptomatic knee group showed an increase for the Kujala score and a decrease for the numeric rating scale (NRS) variable from baseline to 1 week. VISA-P score did not show statistically significant differences for the time-group interaction. After the intervention, there were no differences between the groups in any measured time. Conclusion: a single-shot ultrasound-guided PNM intervention per week in the femoral nerve may be an effective treatment for improving the pain, knee flexion ROM, and knee functionality. In addition, this technique produces crossover benefits in the nonintervention limb.

Background: Hallux valgus (HV) has been previously associated with psychological disorders. Thus, the purposes of this study were to associate kinesiophobia and pain intensity with HV deformity degrees, as well as predict kinesiophobia and pain intensity based on HV deformity and demographic features. Methods: A cross-sectional study was carried out recruiting 100 subjects, who were divided into HV deformity degrees, such as I-no HV (n = 25), II-mild (n = 25), III-moderate (n = 25), and IV-severe (n = 25) HV. Kinesiophobia total and domains (activity avoidance and harm) scores and levels were self-reported by the Tampa Scale of Kinesiophobia (TSK-11). Pain intensity was self-reported by the numeric rating scale (NRS). Results: Statistically significant differences (p &lt, 0.01, &eta, 2 = 0.132&ndash, 0.850) were shown for between-groups comparison of kinesiophobia total and domain scores (activity avoidance and harm) and levels, as well as pain intensity among HV deformity degrees. Post hoc comparisons showed statistically significant differences with a large effect size (p &lt, 0.05, d = 0.85&ndash, 4.41), showing higher kinesiophobia symptoms and levels and pain intensity associated with greater HV deformity degrees, especially for III-moderate and/or IV-severe HV deformity degrees versus I-no HV and/or II-mild deformity degrees. Both statistically significant prediction models (p &lt, 0.05) for kinesiophobia (R2 = 0.300) and pain intensity (R2 = 0.815) were predicted by greater HV deformity degree and age. Conclusions: Greater kinesiophobia symptoms and levels and pain were associated with higher HV deformity degrees, especially severe and/or moderate HV with respect to no and/or mild HV. The kinesiophobia and pain intensity were predicted by greater HV deformity degree and age.

Background and objectives: The repetitive loading forces generated during football activities may induce alterations in the hip rotation range of motion (ROM) in players. The objective of this study was to evaluate the acute effects of a training and a match on bilateral passive hip rotation ROM in both lower limbs in soccer. Material and methods: Twenty-eight male players were divided into two groups: 14 players (28 limbs) with normal bilateral hip rotation ROM (NH group) and 14 players (28 limbs) with restricted bilateral hip ROM (RH group). Passive bilateral hip rotation ROM was measured, by goniometer, before and after training or a match. Internal-rotation ROM (ROMIR), external-rotation ROM (ROMER), total ROM (ROMTOT) and relative internal rotation (ROMREL) were calculated. Results: The NH group did not show substantial changes in hip ROM after a training nor a match. After a training session, only the RH group exhibited a substantial increase in ROMIR, ROMER and ROMTOT. After a match, only the RH group exhibited a substantial increase in ROMER and ROMTOT and exhibited a substantial decrease in ROMREL. Comparing both groups, there were significant differences within ROM changes for ROMER and ROMTOT after training and for ROMER and ROMREL after a match. Conclusions: Despite the small sample size of the present study, the findings indicate that a single football activity leads to significant changes in hip rotation ROM in players with restricted bilateral hip external-rotation ROM. However, these changes did not reach reference cut-off scores. Sin financiación 2.430 JCR (2020) Q2, 80/169 Medicine, General & Internal 0.530 SJR (2020) Q3, 1256/2448 Medicine (miscellaneous) No data IDR 2019 UEM

Background and Objectives: The purpose of the present study was to quantify and compare lateral abdominal musculature thickness, including the transverse abdominis (TrA), internal oblique (IO), and external oblique (EO) muscles, via rehabilitative ultrasound imaging (RUSI) during the use of the expiratory flow control device (EFCD) versus the classic abdominal drawing-in maneuver (ADIM). Materials and Methods: A cross-sectional observational pilot study. Twenty-one women were recruited and assessed the thickness of each muscle (TrA, IO, and EO) by ultrasound imaging at rest, during the ADIM, and during expiration with the EFCD. Waist circumference was also measured under the same circumstances. Results: Statistically significant differences were observed between ADIM, EFCD, and at rest condition for the thickness of the TrA (p = 0.001) and IO (p = 0.039). Moreover, statistically significant differences for TrAb at rest compared with the ADIM (p = 0.001, Cohen&rsquo, s d = 2.183) and at rest and with the EFCD (p = 0.001, Cohen&rsquo, s d = 2.843). In addition, between ADIM and EFCD were not statistically significant, although a moderate effect size was found (p = 0.055, Cohen&rsquo, s d = 0.694). For the IO muscle thickness, significant differences were reported between the EFCD and at rest (p = 0.038), Cohen&rsquo, s d = 0.081). Conclusions: Significant differences in the increase of the thickness of the TrA and IO muscles during the use of the EFCD and the ADIM with respect to rest. In addition, for the TrA, statistically significant differences were found during expiration with the EFCD with respect to the ADIM. Expiration with EFCD can be a useful method for the activation of the TrA.

Background: The prevalence of back pain in adolescents is steadily increasing, with negative repercussions on students&rsquo, social and academic life. This study sought to improve the ergonomics and musculoskeletal health of adolescents in secondary school by implementing physiotherapy actions within the educational context. Methods: A qualitative collaborative action research approach was used, comprising 49 students, 9 teachers, 11 family members, and 9 physiotherapists. Workshops on ergonomics, stretching, and massage were held. Visual materials were developed to support the assimilation of the information given at the workshops. Data collection included field notes, reflexive diaries, in-depth interviews, and discussion groups. The data were analyzed using the Atlas.ti 6.0 program (Scientific Software Development GmbH, Berlin, Germany). Results: The presence of a physiotherapist in the school context facilitates the acquisition of healthy postural habits. All the adolescents perceived a decrease in back pain after undergoing the program. Conclusions: physiotherapy activities offer students new tools to decrease their back pain and improve their health.

Background: Functional hallux limitus (FHL) refers to dorsiflexion hallux mobility limitation when the first metatarsal head is under loading conditions but not in the unloaded state. The goal of the study was to evaluate 3 common manual tests (Buell, Dananberg, and Jack tests) for assessing first metatarsophalangeal joint (MPJ) mobility and determining the normal values needed to detect FHL, and clarify the signs and symptoms associated with this pathology. Methods: Forty-four subjects were included in this reliability study. Subjects were divided into healthy control (non-FHL) and FHL groups according to the Buell first MPJ limitation values in addition to signs and symptoms derived from the literature. In both groups, we measured the mobility in the Buell, Dananberg, and Jack tests using a goniometer; their intraclass correlation coefficients (ICCs), sensitivities, and specificity indexes were also calculated. Results: All techniques showed high reliability across measurement trials with ICCs ranging from 0.928 to 0.999. The optimal mobility grades for predicting FHL were 68.6 ± 3.7 degrees, 21 ± 5.9 degrees, and 25.5 ± 6.5 degrees (mean±SD) ( P < .05) for the Buell, Dananberg, and Jack tests, respectively. Conclusion: Normal and limited mobility values were established for assessing FHL using each technique. The sensitivity and specificity data were perfect for the Dananberg and Jack tests, thus identifying these tests as specific and valid tools for use in FHL diagnosis. Pinch callus was the sign most associated with FHL. Level of Evidence: Level II, comparative series.

IntroductionIn childhood, juvenile obesity affects the functional characteristics of the lower limb, predisposing children to pain, discomfort and musculoskeletal comorbidities. This cross-sectional descriptive study analyses the relationship between childhood overweight/obesity and foot/lower limb pain in a population of primary school children.Material and methodsThe study population consisted of 150 children aged 9–12 years recruited at a primary school in Malaga (Spain). None had pathologic feet. Anthropometric and demographic data were compiled by questionnaire and by personal interview. Among other variables, the foot posture index was calculated and knee alignment was measured. In the statistical analysis, the dependent variables considered were foot and lower limb pain, and the predictor variables were age, sex, body mass index, sports activity, foot posture index and knee alignment. A descriptive analysis of these variables was performed, together with an association analysis (using the 2 test) and a multivariate analysis (using binary logistic regression).ResultsIn the study sample, 47.3% were girls, 15.3% were overweight and 12.7% obese. The overall prevalence of foot pain was 10.7% and that of lower limb pain, 27.3%. Of the study variables analyzed, the only ones significantly related to both foot pain and lower limb pain were overweight and obesity.ConclusionsOverweight and obesity are the main factors related to pain in the feet and lower limbs in primary school children.

[Resumen] Introducción: El valgo dinámico de rodilla es uno de los principales factores de riesgo de lesión de deportes de impacto como el Baloncesto. Mejorar los sistemas de análisis de identificación de los factores de riesgo y los protocolos de prevención de lesiones se ha convertido en uno de los objetivos principales del fisioterapeuta deportivo, con el objetivo de disminuir el riesgo de lesión del deportista. Material y Métodos: Se analizó la distribución de las presiones plantares y los ángulos de alineación de los segmentos corporales en el plano frontal durante el Single-Leg-Squat Test en 10 sujetos deportistas de élite, con el objetivo de y observar la modificación a corto plazo asociada a la activación isométrica del glúteo medio y la musculatura intrínseca de la planta del pie. Resultados: Variaciones significativas en el aumento de la presión plantar del primer metatarsiano se registraron tras la activación del glúteo medio y de la musculatura intrínseca del pie. No se obtuvieron resultados significativos en la modificación de los ángulos de alineación en el plano frontal. Conclusiones: Un aumento de la presión plantar de la cabeza del primer metatarsiano puede relacionarse con una mayor estabilidad del miembro, mediante la activación del glúteo medio y de la musculatura intrínseca del pie. Son necesarios estudios con muestras más amplias que correlacionen los datos obtenidos en una muestra más homogénea. [Abstract] Introduction: Dynamic knee valgus is one of the main injury risk factors of impact sports such as basketball. Systems improvement for the analysis of identification of risk factors and injury prevention protocols has become one of the main objectives of the sports physiotherapist, with the aim of reducing the risk of athletes injury. Material and Methods: The distribution of plantar pressures and the angles of alignment of the body segments in the frontal plane during the Single-Leg-Squat Test in 10 elite athletes was analyzed, with the objective of observing the modification in short-term associated with the isometric activation of the gluteus medius and the intrinsic plantar musculature of the foot. Results: Significant variations in the increase of plantar pressure of the first metatarsal were recorded after activation of the gluteus medius and the intrinsic plantar muscles of the foot. No significant results were obtained in the modification of the alignment angle in the frontal plane. Conclusions: An increase in the plantar pressure of the head of the first metatarsal can be related to greater stability of the limb, through activation of the gluteus medius and the intrinsic plantar muscles of the foot. Studies with larger samples that correlate the data obtained in a more homogeneous sample are necessary.

[Abstract] The purpose of this study was to assess and compare with rehabilitative ultrasound imaging (RUSI) the perimuscular connective tissue (PMCT) and interrecti distance (IRD) between elite and amateur basketball players. A sample of 22 healthy basketball players was included and divided into two groups: elite basketball players from Spanish 1st division (n = 11) and amateur basketball players from an entertainment Spanish division (n = 11). Ultrasound images of the external oblique (EO), internal oblique (IO), transversus abdominis (TrAb), rectus anterior (RA) and IRD PMCT were measured and analysed by the ImageJ software. Measurements of abdominal wall muscles PMCT present statistically differences (P < .05) for an increase of perimuscular connective tissue of external oblique (PMCTEO), perimuscular connective tissue of transversus abdominis (PMCTTA) of the left side and an increase of PMCTEO on the right side in favor of the elite group. Rather, the study showed statistically differences (P < .05) for a decrease of perimuscular connective tissue between the internal oblique and transversus abdominis (PMCTIO-TA), and a decrease in PMCT total summation of the left side with elite group in respect to amateur group. This study reported an increase of left PMCTEO, left PMCTTAA, right PMCTEO as well as a decrease of left PMCTIO-TA and in PMCT total summation on the left side. [Resumo] O objetivo deste estudo foi avaliar e comparar com ultrassonografia de reabilitação (IUR) o tecido conjuntivo perimuscular da parede abdominal (PMPA) e interrecti distância (IRD) entre elite e jogadores de basquete amadores. Uma amostra de 22 jogadores de basquete saudáveis foi incluída e dividida em dois grupos: jogadores de basquete de elite da 1ᵃ divisão espanhola (n=11) e jogadores de basquete amadores de uma divisão de entretenimento espanhol (n=11). As imagens de ultrassom do oblíquo externo (OE), oblíquo interno (OI), transverso abdominal (TrAb), recto anterior (RA) e IRD PMPA foram medidas e analisadas pelo software ImageJ. Medições dos músculos da parede abdominal O PMPA apresentam diferenças estatisticamente (P

Objective To determine the influence of depression symptoms and levels in athletes with gastrocnemius myofascial pain with respect to healthy athletes. In addition, to determine a prediction model for kinesiophobia symptoms based on descriptive data and gastrocnemius myofascial pain presence. Design Secondary case-control. Setting Outpatient clinic. Participants A sample of 50 athletes was recruited and divided into athletes with chronic gastrocnemius myofascial pain (n = 25) and healthy athletes (n = 25). Main outcome measurements Depression symptoms scores and levels were self-reported by athletes using the Beck Depression Inventory – II (BDI-II). Results Statistically significant differences for depression symptoms scores (P = 0.011) with a moderate effect size (d = 0.77) and depression levels (P = 0.036) were found between both groups showing greater depression symptoms and levels in athletes with gastrocnemius myofascial pain (13.00 ± 13.50 points; range from 0 to 28 points) versus healthy athletes (4.00 ± 7.00 points; range from 0 to 19 points). Higher depression symptoms scores of BDI-II were only predicted by the presence of gastrocnemius myofascial pain in athletes (R2 = 0.134; β = +5.360; F[1,48] = 7.428; P = 0.009). Conclusions Greater depression symptoms and levels were exhibited for athletes with gastrocnemius myofascial pain compared to healthy athletes. In addition, depression score of athletes was only predicted by the presence of gastrocnemius myofascial pain. Sin financiación 2.365 JCR (2020) Q2, 32/68 Rehabilitation 0.906 SJR (2020) Q1, 42/210 Physical Therapy, Sports Therapy and Rehabilitation No data IDR 2019 UEM

The aims of this research were to evaluate and compare the effect in a matched sample of patients with type II and type I diabetes scores using a specific quality‐of‐life (QoL) tool related to overall and foot health (Foot Health Status Questionnaire [FHSQ]). A sample of 62 patients with an age median of 59.00 ± 19.00 y were divided into type I (n = 31) and type II (n = 31) diabetes groups. Socio‐demographics data include: (1) age, (2) gender, (3) body mass index, (4) professional activity, (5) study level, and (6) civil status. The FHSQ was used to evaluate foot (pain, function, footwear, and general health section I domains) and overall (general health, social capacity, physical activity, and vigour section II domains) health related to QoL. Differences between groups were assessed by means of a t test or Mann‐Whitney U test for independent samples. There were no statistically significant differences (P > 0.05) for any socio‐demographic data. Regarding the FHSQ section II of the specific foot health‐related QoL, the only statistically significant differences (P = 0.042) were observed for the general foot health showing a QoL impairment (lower median ± interquartile range) in patients diagnosed with type II diabetes (60.00 ± 60.00 points) compared with patients who suffered from type I diabetes (25.00 ± 72.50 points). The other domains did not show any statistically significant differences (P > 0.05). Patients with type II diabetes present a negative impact on the specific foot health‐related QoL compared with patients who suffered from type I diabetes. Sin financiación 2.825 JCR (2019) Q2, 21/68 Dermatology, 53/210 Surgery 0.877 SJR (2019) Q1, 28/146 Dermatology, 90/451 Surgery No data IDR 2019 UEM

Purpose: Abdominal muscles are key in maintaining body stability and balance and an improvement in the functioning of these muscles could influence the rehabilitation process in lower limb pathologies such as Achilles Tendinopathy (AT). The aim was to explore whether calf eccentric exercise (EE) with vibration training was more effective at causing adaptation to the rectus anterior (RA) thickness and inter-rectus distance (IRD) than calf EE with cryotherapy. Methods: The investigation was a single-blinded, randomized, controlled clinical trial (NCT03515148). Sixty-one individuals diagnosed with mid-portion AT were recruited and divided in two groups: group A (n = 30) followed an EE with vibration program and group B (n = 31) an EE program with cryotherapy, for 12-weeks. RA muscle thickness and IRD were measured in maximal isometric contraction and at rest as an indication of superficial abdominal muscle activation. Results: IRD measures showed a significant (P < 0.05) decrease at baseline, 4 and at 12-weeks in both groups, but no significant differences were observed between the intervention groups. RA thickness was significantly increased (P < 0.05) in measures at baseline, 4 and 12-weeks showed a significant increase in maximal isometric contraction and at rest in favor of the EE vibration program group. Conclusions: The present study showed a RA thickness increase in both groups in favor of the EE vibration program with respect to cryotherapy added to EE in short and mid term in maximal isometric contraction and at rest in subjects with chronic mid-portion AT. IRD was decreased in both groups without between-groups differences. Sin financiación 2.333 JCR (2018) Q2, 53/160 Medicine, General and Internal 0.834 SJR (2018) Q2, 740/2844 Medicine (miscellaneous) No data IDR 2018 UEM

Background: Classical medial wedge (CMW) orthoses have been prescribed to treat overpronation foot pathologies in runners. The effects of a novel supination orthosis (NSO) on the surface electromyography (EMG) activity of the peroneus longus (PL) muscle during a complete cycle of running have yet to be tested. Purpose/Hypothesis: The purpose of this study was to compare the EMG activity of the PL in participants wearing CMW orthoses and NSOs versus neutral running shoes (NRS) during a full cycle of running gait. It was hypothesized that the PL muscle activity would be lower for the NSO compared with CMW or NRS. Study Design: Controlled laboratory study. Methods: Included were 31 healthy recreational runners of both sexes (14 male and 17 female; mean age, 38.58 ± 4.02 years) with a neutral Foot Posture Index and standard rearfoot-strike pattern. Participants ran on a treadmill at 9 km/h while wearing NSO (3-, 6-, and 9-mm thicknesses), CMW (3-, 6-, and 9-mm thicknesses), and NRS, for a total of 7 different conditions randomly selected, while the EMG signal activity of the PL was recorded for 30 seconds. Each trial was recorded 3 times, and the intraclass correlation coefficient (ICC) to test reliability of the measurements was calculated. The Wilcoxon pair to pair nonparametric test with Bonferroni correction was performed to analyze differences among the conditions. Results: The reliability of all assessments was almost perfect (ICC, >0.81). For both the CMW and NSO, regardless of thickness, the PL activity was statistically significantly lower compared with the NRS ( P < .05 for all). For all CMW thicknesses, the PL activity was lower compared with the respective NSO thicknesses, with the 3-mm thickness having the largest difference (CMW3mm, 18.63 ± 4.64 vs NSO3mm, 20.78 ± 4.99 mV; P < .001). Conclusion: Both CMW and NSO produced reduced EMG activity of the PL muscle; therefore, they can be prescribed to treat overpronation pathologies without associated PL strain concerns. In addition, the NSO saved the enhancement material placed on the medial-rear side of CMW, making it easier to wear sports shoes. Clinical Relevance: Knowing the safety of CMW and NSO will aid in understanding treatments for overpronation pathologies.

Objective: The aim was to analyze effects of a percutaneous neuromodulation (PNM) treatment on the radial nerve, regarding pain, functionality, electrophysiologic excitability, and morphology, in patients with chronic lateral epicondylalgia (LE). Methods: Twenty-four patients with chronic unilateral elbow pain were recruited for this preliminary study and were divided into two groups: control (n = 12) and PNM group (n = 12). The subjects in the PNM group received percutaneous peripheral neurostimulation with an acupuncture needle that was located next to the nerve with ultrasound guidance. Pain using a numerical rating scale (NRS), functional ability using patient-rated tennis elbow evaluation (PRTEE), radial nerve cross-sectional area measured by ultrasound, and chronaxie and accommodation index (AI) measured by the strength–duration curve were evaluated. Results: Both groups showed no differences in the baseline measurements (all p = 0.001). However, at the end of the treatment, there were significant differences between groups since only the PNM group significantly improved their values compared to their baseline values: level of pain and cross-sectional area (CSA) values showed a significant decrease while the PRTEE scores showed a significant improvement. Then, regarding AI, the PNM group showed significant improvement for the electrophysiologic nerve excitability pattern, reporting normal function in all radial nerves after treatment (p = 0.001). However, chronaxie values always reported similar values with no differences between groups (p &gt, 0.05), Conclusion: Ultrasound-PNM technique may be an interesting therapeutic tool for the treatment of chronic LE due to the improvement in the level of pain, functionality, nerve morphology, and excitability in this population.

Cervicobrachial pain (CP) is a highincidence and prevalent condition. Cervical lateral glide (CLG) is a firstline treatment of CP. There is a current lack of enough high-quality randomized controlled double-blind clinical trials that measure the effectiveness of neural tissue mobilization techniques such as the CLG and its specific effect over CP. The aim of the present study was to assess the effect of CLG neural mobilization in treating subjects who suffer from CP, compared with the complete absence of treatment. This investigation was a singlecenter, blinded, parallel randomized controlled clinical trial (RCT). One hundred forty-seven individuals were screened in a medical center from July to November 2015. Fifty-eight participants were diagnosed with CP. . Participants were recruited and randomly assigned into two groups of 29 subjects. The intervention group received CLG treatment, and the control group (CG) was assigned to a six-week waiting list to receive treatment. Randomization was carried out by concealed computer software randomized printed cards. The primary outcome was pain intensity, reported through the Numeric Rating Scale for Pain (NRSP). Secondary outcomes were physical function involving the affected upper limb using the Quick DASH scale and ipsilateral cervical rotation (ICR) using a CROM device. Assessments were made at baseline and one hour after treatment. The CLG group NRSP mean value was significantly (P< 0.0001) superior to those obtained by the CG. Subjects treated with CLG reported an average NRSP decrease of 2.16 points (35%). CROM device and Quick DASH outcome values also reported significant (P < 0.0001) improvements only in the CLG group. Cohen’s d showed a very large effect of the CLG intervention at subject discharge. Due to the lack of dipper subgroup analysis and additional reproductions of the applied protocol, the authors considered the generalization of the study results to be impossible. CLG is superior to the absence of treatment in reducing pain and increasing the affected upper limb function of subjects who suffer from CP. CLG may be considered an effective treatment in specific cases of CP. Sin financiación 2.782 JCR (2017) Q1, 35/154 Medicine, General and Internal; Q2, 13/31 Anesthesiology 1.087 SJR (2017) Q1, 20/129 Anesthesiology and Pain Medicine, 512/2878 Medicine (miscellaneous); Q2, 109/378 Neurology (clinical) No data IDR 2017 UEM

Purpose: The goal of the present study was to assess, by ultrasound imaging (USI), the thickness of the plantar fascia (PF) at the insertion of the calcaneus, mid and forefoot fascial locations, and the calcaneal fat pad (CFP) in patients with Achilles tendinopathy (AT). Methods: An observational case-control study. A total sample of 143 individuals from 18 to 55 years was evaluated by USI in the study. The sample was divided into two groups: A group composed of the chronic non-insertional AT (n = 71) and B group comprised by healthy subjects (n = 72). The PF thicknesses at insertion on the calcaneus, midfoot, rearfoot and CFP were evaluated by USI. Results: the CFP and PF at the calcaneus thickness showed statistically significant differences (P &lt, 0.01) with a decrease for the tendinopathy group with respect to the control group. For the PF midfoot and forefoot thickness, no significant differences (P &gt, 0.05) were observed between groups. Conclusion: The thickness of the PF at the insertion and the CPF is reduced in patients with AT measured by USI.

Background: Hallux abductus valgus (HAV) is a forefoot condition produced by extrinsic and intrinsic factors. Shoes with a high heel height and a typical narrow tip toe box can induce deviations in both the proximal phalanx of the hallux (PPH) and the first metatarsal (IMTT) bones. Nevertheless, the isolated role of heel height remains unclear in the development of HAV pathology. Objectives: The goal was to determine if the heel height increase of shoes without a narrow box toe could augment the PPH and IMTT deviation in frontal, sagittal, and transverse planes toward the first metatarsophalangeal joint (MPJ) and the first metatarsocuneiform joint (MCJ), respectively, during static and dynamic conditions in relation to precursor movements of HAV. Methods: Women with an average age of 25.10 &plusmn, 4.67 years were recruited in this cross-sectional study to assess the three planes of motion of PPH and IMTT while wearing high heels with heights at 3, 6, 9 cm and unshod conditions via sandals. The measurements used an electromagnetic goniometer device with sensors placed on medial aspects of the PPH and IMTT bones under static and dynamic conditions. Results: Wearing shoes with a 6 cm heel in dynamic condition may increase the PPH valgus and abduction deviation from 3.15 &plusmn, 0.10&deg, to 3.46 &plusmn, 0.05&deg, (p &lt, 0.05) and from 1.35 &plusmn, 0.28&deg, to 1.69 &plusmn, 0.30&deg, 0.001), respectively. In addition, a PPH abduction increase from 1.01 &plusmn, 0.36&deg, to 1.31 &plusmn, 0.46&deg, 0.05) after wearing shoes with a 6 cm heel height was observed under static conditions. Conclusions: Wearing shoes with a heel height of 6 cm without a narrow box toe interference may produce PPH abduction and valgus deviations related to HAV formation.

Objective High demand of flexor hallucis longus (FHL) in the positions of extreme flexion of the ankle and toes is required in the dance. The aim was to investigate the effects of single-shot of ultrasound-guided percutaneous neuromodulation (PNM) vs. single-shot of transcutaneous electrical nerve stimulation (TENS) in performance of the FHL muscle in professional dancers. Materials and Methods Thirty-two female healthy dancers were divided into two groups: TENS group and PNM group. The stimulation interventions consisted in the application of a square wave biphasic electrical current for a total of 1.5 mins. Range of motion (ROM) of first metatarsophalangeal joint, balance test, and unilateral heel raise fatigue test were performed in dominance limb. Results There were no differences between both groups in the baseline measurements. Compared to their baseline values, the TENS group statistically improved balance (p < 0.01, d = 0.6), ROM (p < 0.001, d = 0.3), and endurance (p = 0.04, d = 0.5). The PNM group only statistically improved balance and endurance (p < 0.001), with a large effect size for both test (d = 0.8 and d = 2.24, respectively). After interventions, there were no significant differences between TENS and PNM groups for all variables. However, PNM was qualitatively more effective because the percentage change in mean was greater and effect size was large for the balance test and endurance test. Conclusions Simple single-shot procedure with percutaneous or TENS provided immediate performance improvement of FHL muscle in dancers, being PNM the more effective intervention. Sin financiación 4.722 JCR (2020) Q2, 54/208 Clinical Neurology 1.296 SJR (2020) Q1, 17/122 Anesthesiology and Pain Medicine No data IDR 2020 UEM

Purpose: To compare and quantify with ultrasound imaging (USI) the inter-recti distance (IRD), rectus abdominis (RA), external oblique (EO), internal oblique (IO), transversus abdominis (TrAb), and multifidus thickness and the RA and multifidus cross-sectional area (CSA) between individuals with and without chronic mid-portion Achilles tendinopathy (AT). Methods: A cross-sectional study. A sample of 143 patients were recruited and divided into two groups: A group comprised of chronic mid-portion AT (n = 71) and B group composed of healthy subjects (n = 72). The IRD, RA, EO, IO, TrAb, and multifidus thickness, as well as RA and multifidus CSA, were measured by USI. Results: USI measurements for the EO (p = 0.001), IO (p = 0.001), TrAb (p = 0.041) and RA (p = 0.001) thickness were decreased as well as IRD (p = 0.001) and multifidus thickness (p = 0.001) and CSA (p = 0.001) were increased for the tendinopathy group with respect the healthy group. Linear regression prediction models (R2 = 0.260 − 0.494; p < 0.05) for the IRD, RA, EO, and IO thickness (R2 = 0.494), as well as multifidus CSA and thickness were determined by weight, height, BMI and AT presence. Conclusions: EO, IO, TrAb, and RA thickness was reduced and IRD, multifidus thickness and CSA were increased in patients with AT. Sin financiación 3.706 JCR (2020) Q2, 45/169 Medicine, General & Internal 0.622 SJR (2020) Q3, 70/121 Clinical Biochemistry No data IDR 2019 UEM

Objective To compare the thickness and cross-sectional area (CSA) of the Abductor Hallucis Brevis (AHB), Flexor Digitorum Brevis (FDB) and Flexor Hallucis Brevis (FHB) in subjects with and without chronic mid-portion Achilles tendinopathy (AT). Design A case-control research study. Setting A private clinic. Participants A total sample of 143 subjects was recruited for the study and divided in two groups, such as chronic mid-portion AT group (n = 71) and healthy group (n = 72). Main outcome measures Ultrasound B-Mode imaging was used to measure the thickness and CSA of the AHB, FDB and FHB in subjects with and without chronic mid-portion AT at rest. Results USI measurements of the AHB (p

AIM: The aim of the present study was to evaluate and quantify with ultrasound imaging (USI) the Achilles tendon thickness, cross-sectional area (CSA), Kager's fat pad length and gastrocnemius-soleus pennation angle (PA) between chronic mid-portion Achilles tendinopathy (AT) and healthy subjects. METHODS: A total sample of 143 individuals (age: 41.3 ± 12.0 y; height: 1.74 ± 0.0 m; weight: 75.0 ± 11.4 kg; body mass index, BMI: 24.4 ± 2.6 kg/m2) was recruited and divided in two groups: chronic mid-portion AT group (n = 71) and a healthy group (n = 72). RESULTS: The thickness and CSA at 4 cm and 6 cm from the calcaneus was increased showing statistically significant differences (P

Quantitative ultrasound imaging of the muscle tissue may be applied in the neurology field, due to B-mode grayscale pixels values could be used as potential biomarkers for disease progression and intervention effects in poststroke patients. Thus, the study aim was to compare and analyze the ultrasound imaging B-mode pixels differences between the intrinsic plantar muscles cross-sectional area (CSA) in hemiparetic and contralateral feet from poststroke patients by means of the Image J software. A case-control design and a convenience sampling method were used in order to recruit 22 feet from 11 poststroke patients. This total sample was divided into 11 hemiparetic feet and 11 contralateral feet. The Image J software was used in order to evaluate the interface distance, CSA as well as measure the pixels mean, standard deviation (SD) and count from all offline images in the flexor digitorum brevis, abductor hallucis (AbH), and flexor hallucis brevis muscles. Statistically significant differences (p = 0.003) were only shown for the pixels count in the AbH muscle. The rest of outcome measurements did not show any statistically significant difference (p &gt, 0.05). Therefore, B-mode ultrasound imaging Image J software differences for the pixels count reduction were shown in the AbH muscle between hemiparetic and contralateral feet from poststroke patients. Further studies are necessary in order to apply our findings as potential biomarkers during the stroke disease course.

The aim of our study was to evaluate the efficacy and safety of topical cantharidin-podophylotoxin-salicylic acid (CPS) treatment of recalcitrant plantar warts (RPW). This study was carried out in a health center in the city of A Coruna (Spain) between January and December 2013. A total of 75 patients completed all the stages of the research process. Information related to treatment with CPS and adverse effects was abstracted from medical records. Of 93 potential patients identified, 75 had at least one follow-up visit or telephone call after treatment and were included in this study. Patients experienced an average of 5.4 visits until complete resolution of their plantar wart occurred, although CPS was not applied at every visit. Fifty-four patients required one application to eliminate the wart and 21 patients required two applications/patient. Seventy-seven percent of patients experienced blistering - an expected therapeutic side effect. All patients experienced some form of an adverse event, the most common being pain (81.3%) and significant blistering (15%). Other side effects were rare (18.7%) and included pruritus, possible mild infection, significant irritation, and bleeding. All patients reported treatment, supporting our results that CPS is a safe and efficacious treatment modality for RPW and should be considered when symptomatic infection necessitates treatment.

This prospective quasi-experimental study investigated the efficacy of a multitask balance training program to improve the balancing ability of healthy preschool children. A total of 85 (51.8% boys) healthy preschool children aged 4&ndash, 6 years were randomly divided into an intervention group and a control group. The intervention group received a multitask balance training program, while the control group received a placebo training program. Outcomes were collected at baseline and immediately following the intervention. Independent members of the research team recorded balance skill measurements in the cohort at pre- and post-training using the Pediatric Balance Scale (PBS). Balance-related outcomes were recorded using the Battelle Development Inventory in Spanish using the second edition (BDI-II). A significant effect of time interaction (F = 7.27, p = 0.015, F = 6.16, p = 0.02 and F = 7.41, p = 0.014) existed for the PBS and BDI-II over balance immediately after the intervention (p &lt, 0.001 for each). A significant group-by-time interaction was detected for the PBS and BDI-II (p &lt, 0.001 and p = 0.006, respectively). This study supports the efficacy of multitask-based balance training programs to improve balance in children aged 4&ndash, 6 years.

Ankle sprains have been defined as the most common injury in sports. The aim of the present study was to investigate the ankle taping for the reduction of ankle dorsiflexion range of motion (ROM) and inter-limb in elite soccer and basketball players U18 in a single training session. Methods: A cross-sectional pilot study was performed on 38 male healthy elite athletes divided into two groups: a soccer group and a basketball group. Ankle dorsiflexion ROM and inter-limb asymmetries in a weight-bearing lunge position were assessed in three points: with no-tape, before the practice and immediately after the practice. Results: For the soccer group, significant differences (p &lt, 0.05) were observed for the right ankle, but no differences for the asymmetry variable. The basketball group reported significant differences (p &lt, 0.05) for the right ankle and symmetry. Conclusions: Ankle taping decreased the ankle dorsiflexion ROM in youth elite soccer and basketball players U18. These results could be useful as a prophylactic approach for ankle sprain injury prevention. However, the ankle ROM restriction between individuals without taping and individuals immediately assessed when the tape was removed after the training was very low.

[Abstract] Generalized ligamentous hyperlaxity (GLH) has been shown to predispose an individual to a number of orthopaedic conditions. Little is known about how GLH affects people’ foot health-related quality of life. This study analyses a sample of people with GLH and people without GLH with normalised reference values of the scores collected with regard to using the Foot Health Status Questionnaire (FSHQ). A total of 100 respondents with mean age of 22.69 ± 3.78 years old, who attended a health centre were classified as GLH (n = 50) or non-GLH (n = 50). The GLH was determined of the patients with and without GLH using assessment with Beighton tool and the scores on the FHSQ were compared. The control group recorded higher scores in the First Section for foot pain, foot function and general foot health, and lower scores in footwear. In the Second Section, they obtained higher scores in social capacity and lower scores in physical activity, vigour and general health. Differences between the two groups were evaluated through a t-test for independent samples, showing statistical significance (P

The aim of the present study was to evaluate and compare with rehabilitative ultrasound imaging (RUSI) abdominal wall muscle thickness and interrecti distance (IRD) between elite and amateur basketball players. A sample of 32 basketball players (age: 23.0 ± 8.5; height: 1.89 ± 14.25 m; weight: 86.6 ± 15.5 kg; body mass index: 22.8 ± 2.6 kg/m2) was divided in two groups: professional elite and amateur players. A diagnostic ultrasound tool with a 7–14 MHz range linear transducer was used for B mode ultrasound imaging. Ultrasound images of the external oblique (EO), internal oblique (IO), transversus abdominis (TrAb), and rectus anterior (RA) muscles as well as IRD were measured and analyzed by ImageJ software. Statistically significant differences (p < 0.05) with greater height, weight, and Nijmegen scores were shown in favor of the elite basketball players compared to the amateur basketball players. Ultrasound measurements of the abdominal wall muscles showed statistically significant differences (p < 0.05) for increased IRD and left TrAb thickness and decreased right and left EO thickness in favor of the elite versus amateur basketball players. The rest of the measurements did not show any statistically significant differences (p > 0.05). Increased IRD and TrAb thickness and reduced EO thickness may be shown in elite versus amateur basketball players. Sin financiación 2.217 JCR (2018) Q2, 67/148 Physics, Applied; Q3, 89/172 Chemistry, Multidisciplinary, 151/293 Materials Science, Multidisciplinary 0.379 SJR (2018) Q1, 135/789 Engineering (miscellaneous); Q2, 37/130 Fluid Flow and Transfer Processes, 71/443 Instrumentation, 262/653 Materials Science (miscellaneous), 33/91 Process Chemistry and Technology; Q3, 351/1875 Computer Science Applications No data IDR 2018 UEM

Background: Down syndrome is the most common chromosomal abnormality and a cause of intellectual disability. It is also associated with orthopaedic and musculoskeletal problems of the locomotive apparatus, especially of the feet. These problems are believed to have a harmful effect on health, social functioning, and mobility. In addition, these persons generally don’t have access to podiatric health services, even when their foot problems are well known, because of limited access to healthcare facilities. The goal of our research was to evaluate and compare the foot health status of study participants with and without Down syndrome and to determine whether inadequate footwear is being used with normalized reference values. Methods: A total of 105 participants with and without Down syndrome, with a mean age of 35.71 (SD = 12.93) years, were enrolled in the study. They self-reported demographic data and their clinical characteristic data were recorded. Measurements of their foot and shoe fitting were taken at all stages of the research process. Ninety-two percent of the participants with Down syndrome had foot problems. Results: Only 12 (24%) participants with Down syndrome used bilateral shoes that met the requirements of their feet compared to their controls (50 participants, 90.9% for the right foot; 46 participants, 83.6% for the left foot). Participants with Down syndrome presented statistically significant differences with respect to controls and wore incorrectly sized shoe. Conclusions: Evaluation of foot length and width may prevent development of foot deformities, as well as to improve general Sin financiación 2.468 JCR (2018) Q2, 112/251 Environmental Sciences, 67/186 Public, Environmental & Occupational Health 0.818 SJR (2018) Q2, 37/137 Health, Toxicology and Mutagenesis, 157/562 Public Health, Environmental and Occupational Health No data IDR 2018 UEM