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Abstract Background To study the effects of different interventions on automatic gait processing in contrast with voluntary gait processing in healthy subjects. Methods A double-blind randomised controlled trial was designed (120 able-body persons between 18 and 65 years old entered and completed the study), with pre-intervention and post-intervention assessments using the 6-Minute Walk Test (6MWT). The participants were randomly distributed into four groups. Prior to intervention, all participants performed voluntary gait on the ground (VoG) in a calibrated circuit following the 6MWT. The presence of automatic gait (AG) was explored post-intervention without a voluntary demand in the same circuit following the 6MWT. Each group received a different intervention for 30 min: Vojta stimulation, MOTOMED® at no less than 60 revolutions/minute, treadmill walking at 3 km/h, and resting in a chair (control). The main assessment, conducted by a blinded rater, was the difference in distance covered (in meters) during the 6MWT between pre- and post-intervention. Surface electromyography (sEMG) average root mean square (RMS) signals in the right tibialis anterior, right soleus, right rectus femoris, and right biceps femoris were also considered outcome measures. Results The Vojta group was the only one that initiated AG after the intervention (476.4 m ± 57.1 in VoG versus 9.0 m ± 8.9 in AG, p

IntroductionIt is essential to link the theoretical framework of any neurophysiotherapy approach with a detailed analysis of the central motor control mechanisms that influence motor behavior. Vojta therapy (VT) falls within interventions aiming to modify neuronal activity. Although it is often mistakenly perceived as exclusively pediatric, its utility spans various functional disorders by acting on central pattern modulation. This study aims to review the existing evidence on the effectiveness of VT across a wide range of conditions, both in the adult population and in pediatrics, and analyze common therapeutic mechanisms, focusing on motor control modulation.AimThe goals of this systematic review are to delineate the existing body of evidence concerning the efficacy of Vojta therapy (VT) in treating a broad range of conditions, as well as understand the common therapeutic mechanisms underlying VT with a specific focus on the neuromodulation of motor control parameters.MethodsPubMed, Cochrane Library, SCOPUS, Web of Science, and Embase databases were searched for eligible studies. The methodological quality of the studies was assessed using the PEDro list and the Risk-Of-Bias Tool to assess the risk of bias in randomized trials. Methodological quality was evaluated using the Risk-Of-Bias Tool for randomized trials. Random-effects meta-analyses with 95% CI were used to quantify the change scores between the VT and control groups. The certainty of our findings (the closeness of the estimated effect to the true effect) was evaluated using the Grading of Recommendations, Assessment, Development, and Evaluations (GRADE).ResultsFifty-five studies were included in the qualitative analysis and 18 in the meta-analysis. Significant differences in cortical activity (p = 0.0001) and muscle activity (p = 0.001) were observed in adults undergoing VT compared to the control, as well as in balance in those living with multiple sclerosis (p

IntroductionFatigue, postural control impairments, and reduced respiratory capacities are common symptoms in persons diagnosed with Multiple Sclerosis (MS). However, there is a paucity of evidence establishing correlations among these factors. The aim of this study is to analyze respiratory function in persons with MS compared to the control group as well as to analyze the relationship between fatigue, respiratory function and postural control in persons with MS.Materials and methodsA total of 17 persons with MS and 17 healthy individuals were enrolled for this cross-sectional study. The evaluated parameters included fatigue assessed using the Visual Analog Scale-fatigue (VAS-F) and the Borg Dyspnea Scale, postural control assessed through the Mini Balance Evaluation System Test (Mini-BESTest), Berg Balance Scale (BBS), Timed Up and Go (TUG) test, and Trunk Impairment Scale (TIS); and respiratory capacities measured by Maximum Inspiratory Pressure (MIP), Maximum Expiratory Pressure (MEP), Forced Vital Capacity (FVC), Forced Expiratory Volume in the first second (FEV1), FEV1/FVC ratio, Diaphragmatic excursion and diaphragmatic thickness.ResultsA very high correlation was observed between the Borg Dyspnoea Scale and the BBS (r = −0.768), TUG (0.867), and Mini-BESTest (r = −0.775). The VAS-F exhibited an almost perfect correlation solely with the TUG (0.927). However, none of the variables related to fatigue exhibited any correlation with the respiratory variables under study. Balance-related variables such as BBS and Mini-BESTest demonstrated a very high and high correlation. Respectively, with respiratory function variables MEP (r = 0.783; r = 0.686), FVC (r = 0.709; r = 0.596), FEV1 (r = 0.615; r = 0.518). BBS exhibited a high correlation with diaphragmatic excursion (r = 0.591). Statistically significant differences were noted between the persons with MS group and the control group in all respiratory and ultrasound parameters except for diaphragmatic thickness.ConclusionThe findings suggest that decreased postural control and balance are associated with both respiratory capacity impairments and the presence of fatigue in persons with MS. However, it is important to note that the alterations in respiratory capacities and fatigue are not mutually related, as indicated by the data obtained in this study. Discrepancies were identified in abdominal wall thickness, diaphragmatic excursion, and respiratory capacities between persons with MS and their healthy counterparts.

Abstract Purpose To describe the process of delivery of pediatric palliative care from the perspective of a pediatric interdisciplinary team and the children’s parents. Methods A qualitative descriptive case study was conducted. Purposeful sampling took place within a specialized pediatric palliative care Unit in Madrid (Spain), located at the Niño Jesus Hospital. The study participants included a specialized pediatric palliative care team from Madrid's pediatric palliative care program, other professional teams involved in interdisciplinary care and parents of children under pediatric palliative care. Data were collected via semi-structured interviews, focus groups and researchers’ field notes. A thematic analysis was performed. Results This study included 28 participants (20 women, 8 men), of whom 18 were professionals who belonged to the pediatric palliative care interdisciplinary team, 4 professionals were from other units that collaborated with the pediatric palliative care, and 6 were parents (5 women, 1 man). The mean age of the pediatric palliative care members was 38.2 years (SD ± 7.9), that of the collaborating professionals was 40.5 (SD ± 6.8), and that of the parents was 44.2 (SD ± 5.4). Two main themes emerged: a) Pediatric palliative care has a distinct identity, associated with life. It represents the provision of special care in highly complex children, in the context of the home, far from the hospital environment; b) The team is key: its interdisciplinary organization provides a more comprehensive view of the child and their family, fosters communication among professionals, and improves coordination with other services involved in the care of children. The mindset shift experienced by ID-PPC professionals towards a palliative approach makes them more sensitive to the needs of their patients and leads them to develop specific skills in areas such as communication, decision-making, and adaptability that were identified as differentiating aspects of pediatric palliative care. Conclusions Describing pediatric palliative care from the professional and parental perspective helps to establish realistic and comprehensive goals for the care of children and their parents. The findings of this study may help with the establishment of a pediatric palliative care team, as a necessary organizational change in a health care system that cares for children with complex and life-threatening conditions. Promoting training in pediatric palliative care, prioritizing more horizontal organizations, providing tools and spaces for coordination and communication between professionals from different services, together with the creation of a position of case coordinator in the care process of children could enhance the understanding of pediatric palliative care services.

El objetivo de este estudio es conocer la evolución de las marcas acreditadas por la categoría absoluta masculina y absoluta femenina en la prueba “100 metros remolque de maniquí con aletas”. Además, se pretende identificar aquellos factores que han podido provocar cambios de tendencia en la evolución de los tiempos logrados en esta prueba. Para ello, se recopilaron las tres mejores marcas de la categoría absoluta masculina y femenina logradas en 13 Campeonatos de España de Invierno de la Modalidad Deportiva de Salvamento y Socorrismo. El periodo de tiempo analizado en este estudio es el comprendido entre los años 2008 y 2020. Los resultados mostraron que, a lo largo del periodo estudiado, las marcas acreditadas en la prueba “100 metros remolque de maniquí con aletas” han mostrado una evolución positiva. Esta evolución ha sido más notoria en la categoría femenina que en la masculina. El promedio de las tres mejores marcas femeninas mejoró 9,41 segundos (14.56%) mientras que la categoría masculina mejoró 5,97 segundos (11.12%). Además, la eliminación de la norma que obligaba a mantener la permeabilidad de las vías respiratorias del maniquí durante la ejecución de las pruebas y la introducción de aletas de última generación posiblemente han contribuido a la mejora de las marcas.

Resumen: Introducción: el ideario popular, la diseminación a través de redes sociales o la «costumbre» han propiciado diversos mitos sobre el ahogamiento y los incidentes acuáticos que no están basados en evidencias y pueden tener efectos colaterales o limitan la comprensión de este fenómeno. El objetivo de este trabajo ha sido analizar el origen de los mitos más frecuentes relacionados con los incidentes acuáticos y ofrecer una perspectiva científica para su refutación. Materiales y métodos: doce expertos de las Ciencias de la Salud mediante un grupo nominal realizaron el cribado de conceptos en 3 fases: 1ª revisión literatura científica en PubMed en la que se abordasen conceptos erróneos u obsoletos relacionados a los incidentes en entornos acuáticos, 2ª el grupo elaboró un listado de 16 ítems susceptibles de analizar y 3ª se seleccionaron por consenso los mitos considerados más relevantes. Resultados: mediante consenso de expertos y las evidencias disponibles, 10 ítems fueron identificados como potenciales generadores de conceptos erróneos o mitos: el «corte de digestión», el uso de flotadores para prevenir el ahogamiento, hiperventilar antes de bucear, las implicaciones de la bandera roja en las playas, el proceso de ahogamiento, la principal función de los socorristas, orinar sobre picaduras de medusa, la terminología sobre ahogamiento y la reanimación de ahogados. Conclusión: en el ámbito del ahogamiento se sigue utilizando terminología obsoleta y existen creencias populares erróneas que deberían ser actualizadas y desmitificadas, ya que esto podría contribuir a disminuir la incidencia del ahogamiento y sus secuelas. Abstract: Introduction: Popular ideology, dissemination by social networks or the “custom” have fostered numerous myths about drowning and aquatic incidents that are not based on evidence and may be harmful or limit the understanding of this phenomenon. The aim of this paper is to analyze the origin of the most frequent myths related to aquatic incidents and to offer a scientific perspective for their refutation. Materials and methods: Twelve experts in the health sciences by means of a nominal group carried out the screening of concepts in three phases: 1st review of scientific literature in PUBMED in which erroneous or obsolete concepts related to incidents in aquatic environments were addressed, 2nd phase the nominal group elaborated an initial list of 16 items to be analyzed, 3rd phase the final list was refined to 1 by universal consensus of the nominal group. Results: Through expert consensus and available evidence, ten items were identified as potential generators of misconceptions or myths: the “digestion cut-off”, the use of floats to prevent drowning, hyperventilating before diving, the implications of the red flag on beaches, the drowning process, the main role of lifeguards, urinating on jellyfish stings, drowning terminology, and resuscitation of drowned persons. Conclusion: In the field of drowning, obsolete terminology continues to be used and there are erroneous popular beliefs that should be updated and demystified, as this could contribute to reduce the incidence of drowning and its sequelae.

Background: Vojta Therapy is a neurorehabilitation therapy that allows to activate reflex movement patterns. The scientific literature has shown its ability to generate muscle contractions. The activation of brain neural networks has also been proven. However, the relationship between these processes has not yet been demonstrated. For this reason, the aim of this study is to verify brain activation produced by recording with near-infrared spectroscopy and its relationship with muscle activation produced in the abdominal muscles recorded with surface electromyography. Methods: A total sample of 27 healthy subjects over 18 years of age was recruited. An experimental study on a cohort was conducted. Two experimental conditions were considered: stimuli according to the Vojta protocol, and a control non-stimuli condition. Abdominal muscle activation was measured using surface electromyography, and the activation of the motor cortex was assessed with near-infrared spectroscopy. Results: In relation to the oxygenated hemoglobin concentration (HbO), an interaction between the stimulation phase and group was observed. Specifically, the Vojta stimulation group exhibited an increase in concentration from the baseline phase to the first resting period in the right hemisphere, contralateral to the stimulation area. This rise coincided with an enhanced wavelet coherence between the HbO concentration and the electromyography (EMG) signal within a gamma frequency band (very low frequency) during the first resting period. Conclusions: The results underscore the neurophysiological effects on the brain following tactile stimulation via Vojta Therapy, highlighting increased activity in pivotal areas essential for sensory processing, motor planning, and control. This activation, particularly evident in the Vojta stimulation group, aligns with previous findings, suggesting that tactile stimuli can not only evoke the intention to move but can also initiate actual muscle contractions, emphasizing the therapy’s potential in enhancing innate locomotion and rolling movements in patients with neurological disorders.

The Natural Semantic Networks (NSN) model is highly useful in analyzing the words that define a concept in terms of the value, strength, weight, or density that a specific population assigns to the construction of a learned concept. The main objective of this study was to describe the conceptualization of the concept of neurorehabilitation by Spanish physiotherapists specializing in this field using NSN. A phenomenological study is presented. The participants were physiotherapy professionals who graduated from three Spanish universities and were working in the field of neurorehabilitation. A questionnaire was administered via Google Forms, which was constructed using the NSN technique. A total of 191 physiotherapists participated in this study. The Spanish physiotherapists interviewed used a total of 1247 defining words for the concept of neurorehabilitation. The semantic core of the concept was mainly formed by the words ‘treatment’, ‘recovery’, ‘functionality’, ‘neuroplasticity’, and ‘learning’, which carried significant weight. Results were also presented taking into account the academic level and years of professional experience of the sample. The semantic network observed in this study allows us to elucidate the polysemy of the concept of neurorehabilitation, which is composed not only of certain associated words but also the meanings they imply.

The objective of this study is to identify the perception of service receivers about the effects of an acrosport intervention through the Service-Learning methodology. The service was provided to 62 university students with intellectual disability by 35 students of Physical Activity and Sport Science degree. The instruments that were chosen to obtain the information were: the students' reflective journals, the recording of the assemblies that were celebrated just after finishing sessions and the video-diary that they had to elaborate at the end of the semester. A qualitative analysis was performed with the Nvivo-12 Plus software and the following emerged categories and results were obtained: the category on acquired learning in which acrosport contents and the development and importance of interpersonal and intrapersonal skills were referenced; the category on difficulties found related to motor, attention, security and relationship aspects were mentioned; and, finally, the category on feelings in which general feelings and, also, feelings related with classmates, teachers and themselves. In general, we conclude that people who received the service perceived positive effects about the emerged categories pointed.

Abstract Background Brain’s is stimulated by Vojta Therapy through selected body areas activating stored innate motor programs which are exported as coordinate movement and muscle contractions to trunk and limbs. The aim of this pilot study is to know the responses at cortical level to a specific tactile input, assessed by electroencephalography (EEG), compared to a sham stimulation, in healthy subjects. Methods A randomized-controlled trial was conducted. Participants were randomly distributed into two groups: a non-specific tactile input-group (non-STI-group) (n = 20) and a Vojta specific tactile input-group (V-STI-group) (n = 20). The non-STI-group was stimulated in a non specific area (quadriceps distal area) and V-STI-group was stimulated in a specific area (intercostal space, at the mammillary line between the 7th and 8th ribs) according to the Vojta therapy. Recording was performed with EEG for 10 min considering a first minute of rest, 8 min during the stimulus and 1 min after the stimulus. EEG activity was recorded from 32 positions with active Ag/AgCl scalp electrodes following the 10–20 system. The continuous EEG signal was split into consecutive segments of one minute. Results The V-STI-group showed statistically significant differences in the theta, low alpha and high alpha bands, bilaterally in the supplementary motor (SMA) and premotor (PMA) areas (BA6 and BA8), superior parietal cortex (BA5, BA7) and the posterior cingulate cortex (BA23, BA31). For the V-STI-group, all frequency bands presented an initial bilateral activation of the superior and medial SMA (BA6) during the first minute. This activation was maintained until the fourth minute. During the fourth minute, the activation decreased in the three frequency bands. From the fifth minute, the activation in the superior and medial SMA rose again in the three frequency bands Conclusions Our findings highlight that the specific stimulation area at intercostal space, on the mammillary line between 7 and 8th ribs according to Vojta therapy differentially increased bilateral activation in SMA (BA6) and Pre-SMA (BA8), BA5, BA7, BA23 and BA31 in the theta, low and high alpha bands in healthy subjects. These results could indicate the activation of innate locomotor circuits during stimulation of the pectoral area according to the Vojta therapy. Trial registration Retrospectively registered. This randomized controlled trial has been registered at ClinicalTrials.gov Identifier: NCT04317950 (March 23, 2020).

Abstract Background Mansonella perstans infection can be considered one of the most neglected tropical infectious diseases. Very few studies have reported on the clinical picture caused by infection with this nematode. Therefore, our study was aimed to describe the clinical patterns and treatment of imported M. perstans infection by migrants from Africa. Methods The present study evaluated a large cohort of migrants who have been diagnosed, examined and treated for imported M. perstans infection at a Spanish reference center (Hospital Carlos III Tropical Medicine Unit, Madrid, Spain) over a 19-year period. Most patients voluntarily attend the emergency unit or are referred from primary care or general hospitals in Madrid. Chi-square test was used to compare the association between categorical variables. The continuous variables were compared by Student’s t-test or the Mann–Whitney test. The corresponding regression models were used for multivariate analysis. Results Five hundred three cases of migrants from tropical and subtropical areas with M. perstans infection were identified. Two hundred sixty-four patients were female (52.5%). The mean age (± SD) was 44.6 ± 18.2 years (range: 16–93 years). The mean time (± SD) between the arrival in Spain and the first consultation was 8.6 ± 18.0 months. The major origin of the patients was Equatorial Guinea (97.6%). Regarding the clinical picture, 257 patients were asymptomatic (54.7%) and 228 were symptomatic (45.3%); 190 patients had pruritus (37.8%), 50 (9.9%) had arthralgia, 18 patients had Calabar-like swelling (3.6%), and 15 (3%) had abdominal pain. Four hundred forty-two (87.9%) migrants had hyper-IgE, and 340 (67.6%) had eosinophilia. One hundred ninety-five patients had coinfections with other filarial nematodes (38.8%), and 308 migrants had only M. perstans infection (61.2%). Four hundred thirty-seven cases (86.9%) had been treated with anti-filarial drugs; 292 cases were treated with one anti-filarial drug, and 145 cases were treated with combined anti-filarial therapy. Additionally, 20 (4%) cases received steroids and 38 (7.6%) cases received antihistamines. Conclusions A long series of M. perstans infections is presented in sub-Saharan immigrants whose data indicate that it should be included in the differential diagnosis in patients with pruritus or analytical alterations such as eosinophilia or hyper-IgE presentation, and they also have a high number of coinfections with other microorganisms whose treatment needs to be protocolized.

COVID-19 has profoundly disrupted national education systems, affecting the future well-being of school-age children. Bacher-Hicks and colleagues showed that the intensity of the search for online learning resources in the United States doubled with respect to pre-COVID-19 levels. However, areas of the country with higher incomes, better internet access, and fewer rural schools experienced significantly greater increases in search intensity. Using a similar method to study the case of Spain, we analyze the evolution of search intensity for a selection of digital educational resources over the period 2015 to 2021. Special attention is paid to the period of COVID-19 pandemic, namely, March 2020 to June 2021. The findings include a widespread rise in the use of digital resources with respect to the use in the last 5 years, which varies by digital educational resource and region. However, the use of digital resources in Spain does not seem to vary according to family income, at least in relation to open access digital educational resources. In addition, there appears to be a steady decline in search intensity for digital educational resources and a certain degree of substitutability following the surge due to the pandemic and the school closures.

The aging process leads to deterioration in physiological functions, decreasing functional capacity. Since physical exercise reduces deleterious effects, measuring physical condition is necessary in older adults. The aim of this study was to verify the evolution of the range of motion in institutionalized sedentary older adults. The sample consisted of 19 volunteers aged 65-95 years who completed the Chair Sit-and-Reach test (CSR) and the Back-Scratch test (BS) to measure flexibility of the lower and upper limbs, respectively, before and after a period of 12 weeks without intervention. The results showed significant decrease during the control period (BS, p=0.004; CSR, p=0.001). These findings confirm that physical inactivity could lead to important loss of flexibility of institutionalized individuals, indicating decline of the elastic properties of musculoskeletal tissues and of connective tissues of joints. Therefore, the participation of institutionalized older adults in properly prescribed and guided physical exercises should be continuous and regular.

El porcentaje de los españoles que tienen poca o nula confianza en la administración de justicia es del 55 porciento. ¿A qué se debe este nivel de confianza? ¿Depende de factores endógenos, es decir, debido al propiofuncionamiento de la justicia o, por el contrario, hay factores exógenos, como por ejemplo, la ideología, quedetermina la confianza de los individuos en dicha institución? Nuestros resultados indican que los factoresendógenos tienen un peso más importante que los exógenos en la determinación del nivel de confianza.

This article presents the empiral evidences of standardized evaluations and explores the aspects of such evaluations more interesting to the educational community, and investigates the effects in implementing those exams on the performance of students. Furthermore, it is analyzed the relationship between external evaluations and teaching to the test , it is seen how it affects the introduction of these evaluations in student learning and their performance in international assessments of different characteristics, and the effect it produces in schools located in disadvantaged areas.

This article explores the spatial distribution of regional technology indicatorsin the EU over the last decade and its impact on cohesion. Thus, we find thatpublic R&D spending and patent applications have converged among regions duringthe nineties. On the other hand, private R&D activities have diverged, as a result of anasymmetric expansion during the second half of the nineties. We show that when thedispersion of public R&D across regions diminished in the second half of the nineties,income disparities at regional level also decreased. Therefore, while technologypolicy based on efficiency criteria should remain as a policy tool for economicgrowth, this policy should be counterbalanced by R&D funds to the least developedregions to maintain economic cohesion.