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Introduction: During the SARS-CoV-2 pandemic, there has been a decrease in the supervision of the medication of subjects with chronic diseases. Customized automated dosing systems (SPDA) are devices that allow medication to be dispensed and administered, which have proven to be safe and effective for the patient and cost-effective for the healthcare system. Methods: an intervention study was carried out on patients from January to December 2019 in a residential centre for the elderly with more than 100 beds. The economic costs derived from manual dosing were compared with those of an automated preparation (Robotik Technology®). Results: Of the 198 patients included, 195 (97.47%) of them were polymedicated. Of the total of 276 active substances of registered medicinal products, it was possible to include them in the process of automating the preparation of the SPDA 105 active pharmaceutical ingredients. A cost reduction of EUR 5062.39 per year was found using SPDA. Taking into account the active ingredients of emblistable and non-emblistable medicines, the use of SPDA resulted in savings of EUR 6120.40 per year. The system contributed to the detection of cases of therapeutic duplication and reduced the time to prepare the medication. Conclusions: the use of SPDA is a useful and economically profitable strategy for its use in residential centres for the elderly.

Background: The presence of latent myofascial trigger points (MTrPs) in the gluteus medius is one of the possible causes of non-specific low back pain. Dry needling (DN) and ischemic compression (IC) techniques may be useful for the treatment of these MTrPs. Methods: For this study, 80 participants were randomly divided into two groups: the dry needling group, who received a single session of DN to the gluteus medius muscle plus hyperalgesia (n = 40), and the IC group, who received a single session of IC to the gluteus medius muscle plus hyperalgesia (n = 40). Pain intensity, the pressure pain threshold (PPT), range of motion (ROM), and quality of life were assessed at baseline, immediately after treatment, after 48 h, and one week after treatment. Results: Statistically significant differences were shown between the two groups immediately after the intervention, showing a decrease in PPT (p < 0.05) in the DN group and an increase in PPT in the IC group. These values increased more and were better maintained at 48 h and after one week of treatment in the DN group than in the IC group. Quality of life improved in both groups, with greater improvement in the DN group than in the IC group. Conclusions: IC could be more advisable than DN with respect to UDP and pain intensity in the most hyperalgesic latent MTrPs of the gluteus medius muscle in subjects with non-specific low back pain, immediately after treatment. DN may be more effective than IC in terms of PPT, pain intensity, and quality of life in treating latent plus hyperalgesic gluteus medius muscle MTrPs in subjects with non-specific low back pain after 48 h and after one week of treatment.

(1) Background: Introducing ultrasound-guided dry needling to neurorehabilitation treatments increases the beneficial effects of therapy. The aim of this study was to compare the effects of including an ultrasound-guided dry needling session in neurorehabilitation treatment on spasticity and gait–balance quality versus neurorehabilitation treatment in subjects who had suffered a stroke. (2) Methods: A single-blind, randomized clinical trial was conducted. Thirty-six patients who had suffered a stroke in the right middle cerebral artery signed the informed consent for participation in the study. Twenty patients finally participated and were randomly assigned to the control group (neurorehabilitation treatment) or experimental group (neurorehabilitation treatment plus ultrasound-guided dry needling). Pre-treatment and post-treatment data were collected on the same day. The experimental group (n = 10) first underwent an ultrasound-guided dry needling intervention on the tibialis anterior and tibialis posterior musculature, followed by neurorehabilitation treatment; the control group (n = 10) underwent their corresponding neurorehabilitation without the invasive technique. Pre-treatment and post-treatment measurements were taken on the same day, assessing the quality of balance–gait using the “Up and Go” test and the degree of spasticity using the Modified Modified Ashworth Scale. (3) Results: The patients who received neurorehabilitation treatment plus ultrasound-guided dry needling showed a greater decrease in spasticity in the tibial musculature after the neurorehabilitation treatment session (p < 0.001), improving balance and gait (p < 0.001). (4) Conclusions: An ultrasound-guided dry needling session combined with neurorehabilitation treatment reduced spasticity and improved balance and gait in stroke patients.

Background: Osteoarthritis of the knee is one of the most common ailments worldwide, and pain management of this condition is critical. Methods: A multicentre randomized controlled trial RCT with three months of follow-up, conducted in parallel groups: hyaluronic acid (HA), dry needling (DN) and ultrasound (US) and isometrics of quadriceps. 60 participants took part in the RCT who were diagnosed with osteoarthritis (Grade 3) of the knee by MRI and active adults (age: 23.41 ± 1.68 years; height: 1.79 ± 0.08 m; body mass: 78.33 ± 9.03 kg; body mass index (BMI): 24.14 ± 1.45 kg/m2). After the assigned intervention, VAS, WOMAC, IPAQ and the Star Excursion Balance test were measured at baseline. At 24 h, 15 days, 30 days, 90 days and 180 days follow-up, all variables were measured again. Results: Comparing statistically significant differences between groups, VAS scores were significant at post-test measurement (HA vs. US + isometric and DN vs. US + isometric) at 24 h (HA vs. DN), at 15 days (HA vs. US + isometric and DN vs. US + isometric) and at 1 month (US + isometric vs. HA and US + isometric vs. DN). Conclusions: There is an improvement in pain intensity in knee osteoarthritis in the short term in patients undergoing DN and conventional US + isometric treatment, but in the long term the HA group shows an improvement in pain intensity. There is also a significant difference in the improvement of knee function at different phases of the study in the various intervention groups. The combination of DN and HA in clinical practice is the best option for the treatment of osteoarthritis.

Knee examination guidelines in minors are intended to aid decision-making in the management of knee instability.A Delphi study was conducted with a formal consensus process using a validated methodology with sufficient scientific evidence. A group consensus meeting was held to develop recommendations and practical guidelines for use in the assessment of instability injuries in children.there is a lack of evidence to analyse anterior cruciate ligament injuries in children and their subsequent surgical management if necessary. Diagnostic guidelines and clinical assessment of the patient based on a thorough examination of the knee are performed and a guide to anterior cruciate ligament exploration in children is developed.In the absence of a strong evidence base, these established guidelines are intended to assist in that decision-making process to help the clinician decide on the most optimal treatment with the aim of benefiting the patient as much as possible. Following this expert consensus, surgical treatment is advised when the patient has a subjective sensation of instability accompanied by a pivot shift test ++, and may include an anterior drawer test + and a Lachman test +. If these conditions are not present, the conservative approach should be chosen, as the anatomical and functional development of children, together with a physiotherapy programme, may improve the evolution of the injury.

After a physical therapy treatment on the injured knee and a biomechanical study of the position on the bicycle, the symptomatology of the patient's injured knee has improved.

Purpose: To study the prevalence of UI in female athletes, the category of sports with the highest number of cases, the most incident risk factors and the bio-psycho-social consequences. Methods: Preparation of a survey, based on two validated questionnaires answered by 63 participants, to carry out an analytical, transversal and observational study. All participants were European, adult, female athletes (mean age 30.78 years, standard deviation 12.16 years). Results: UI has a high prevalence (44.4%) in female athletes (compared to 10% in non-athletes), being more frequent in those who practice long-distance running. As age and years of sport practice increase, the incidence of this pathology increases. Absorbent pads are used by more than half of women with incontinence, while the rest wet their underwear. Menopause, childbirth and surgery in the region are risk factors for UI, while the presence of urinary tract infections or candidiasis is not. The results state that urine loss does not cause anxiety or depression, but it does affect sporting life. Conclusions: The prevalence of UI in this study is very high and more common in female athletes and the incidence increases with age and other risk factors. The salient consequence of this study is that urine loss affects their sporting environment, but does not induce depression or anxiety.

Objective The purpose of this study was to describe the clinical features in the subacute phase after surgical reconstruction of complete anterior cruciate ligament rupture (ACLR) with respect to healthy participants. Methods A case-control observational study was performed. A total sample of 80 participants was recruited from an outpatient clinic and divided into case (n = 40 patients after ACLR reconstruction in subacute phase) and control (n = 40 healthy participants) groups. Outcomes, including pain intensity, range of motion (ROM), stability, and functionality were assessed by the visual analogue scale, universal goniometer, the Star Excursion Balance Test, and the Western Ontario and McMaster Universities Osteoarthritis Index, respectively. Results There were no statistically significant differences (P > .05) for sex, side, age, and body mass index between patients with ACLR after reconstruction surgery and healthy participants. Statistically significant differences (P < .001) with a large effect size (Rosenthal r) from -0.86 to -0.93 were shown for ROM (median ± interquartile range [IQR], -70.00° ± 10.00°) and Star Excursion Balance Test (mean ± standard deviation, -38.31 cm ± 4.52 cm) reduction, as well as higher visual analogue scale (median ± IQR, 7.00 ± 1.00) and Western Ontario and McMaster Universities Osteoarthritis Index (median ± IQR, 68.77 ± 6.29) scores in favor of the ACLR reconstructed group, with respect to the healthy control group. Conclusions Measurable clinical differences of functionality, stability, and ROM should be considered during the evaluation of patients at a subacute period after complete ACLR reconstruction surgery with respect to healthy matched controls. Sin financiación 1.274 JCR (2018) Q3, 20/27 Integrative & Complementary Medicine, 46/65 Rehabilitation; Q4, 80/98 Health Care Sciences & Services 0.627 SJR (2018) Q1, 3/9 Chiropractics No data IDR 2018 UEM

10 p. Background: Several new rehabilitation modalities have been proposed after anterior cruciate ligament (ACL) reconstruction. Among these, trigger point dry needling (TrP-DN) might be useful in the treatment of myofascial pain syndrome associated with ACL reconstruction to reduce pain intensity, increase knee flexion range and modify the mechanical properties of the quadriceps muscle during late-stage rehabilitation. To date, this is the first randomized clinical trial to support the use of TrP-DN in the early rehabilitation process after ACL reconstruction. The aim of this study was to determine the pain intensity, range of motion (ROM), stability, and functionality improvements by adding quadriceps vastus medialis TrP-DN to the rehabilitation protocol (Rh) provided to subacute ACL reconstructed patients. Methods:This randomized, single-blinded, clinical trial (NCT02699411) included 44 subacute patients with surgical reconstruction of complete ACL rupture. The patients were randomized into 2 intervention groups: Rh (n=22) or Rh+TrP-DN (n=22). Pain intensity, ROM, stability, and functionality were measured at baseline (A0) and immediately (A1), 24hours (A2), 1 week (A3), and 5 weeks (A4) after the first treatment. Results: Comparing statistically significant differences (P .001; Eta2=0.198–0.360) between both groups, pain intensity (at A1), ROM (at A1, A2, and A3), and functionality (at A2, A3, and A4) were increased. Nevertheless, the rest of measurements did not show significant differences (P>.05). Conclusion: Quadriceps vastus medialis TrP-DN in conjunction with a rehabilitation protocol in subacute patients with surgical reconstruction of complete ACL rupture increases ROM (short-term) and functionality (short- to mid-term). Although there was an increase in pain intensity with the addition of TrP-DN, this was not detected beyond immediately after the first treatment. Furthermore, stability does not seem to be modified after TrP-DN. SI

Objetivo: Observar si las lesiones asociadas a una rotura completa de ligamento cruzado anterior (LCA) en pacientes intervenidos con cirugía de reconstrucción influye en la mejoría de la movilidad articular (escala visual analógica, EVA) e intensidad del dolor (ROM) en un protocolo combinado de fuerza y propiocepción.Material y métodos: Se realiza un estudio experimental con 37 sujetos intervenidos de LCA. El promedio de edad fue de 32,4 años (rango: 19-51 años y DT de 8,2 años). Ninguno había sido operado por inestabilidad articular y todos se sometieron a un estudio diagnóstico mediante Resonancia Magnética Nuclear (RNM) previa a la intervención quirúrgica. Para la recuperación se empleó un protocolo combinado de fuerza y propiocepción. Se realizaron mediciones de la EVA y ROM previos al tratamiento, posterior, a las 24 horas, a la semana y a la quinta semana de recuperación.Resultados: El resultado del análisis para los factores intra-sujetos cuyos resultados reflejaron que el EVA y el ROM, mostraron un efecto significativo en el tiempo (de efecto elevado), esto indica que el EVA disminuyó a través del tiempo mientras que el ROM aumentó, independientemente del número de lesiones. No hubo un efecto significativo de la interacción de número lesiones y tiempo.Conclusiones: Los pacientes con varias lesiones asociadas no mostraron diferencias respecto a los que sólo presentaron cirugía de LCA. En ambos grupos reflejan un aumento del ROM a lo largo del tiempo. En ambos grupos existe una disminución del EVA a corto y medio plazo. Objective: To determine if associated injuries with a complete tear of the anterior cruciate ligament (ACL) in patients with reconstruction surgery may influence the improvement of range of movement (ROM) and pain intensity (visual analogue scale, VAS) in a combined protocol of strength and proprioception.Material and Methods: An experimental study was performed with 37 subjects with ACL surgery. The average age was 32.4 years (range: 19-51 years and standard deviation of 8.2 years). None had been previously operated by joint instability and all subjects were diagnosed using Magnetic Resonance Imaging (MRI) prior to surgery, and was confirmed by this additional diagnostic test. For the recovery a combined strength and proprioception protocol was performed. VAS and ROM measurements were carried out before physiotherapy intervention as well as immediately, 24 hours, 1 week and 5 weeks after treatment.Results: The intra-subjects factors analysis showed a significant effect over the time (large effect) for the VAS and ROM, which determined statistically significant VAS reduction and ROM increase over the time, regardless of the number of injuries. Therefore, there was not a significant effect of the interaction between the number of injuries and time.Conclusions: Patients with multiple injuries associated with ACL tear did not show any difference compared to patients who only suffered ACL surgery. A ROM increase and a pain intensity decrease were observed in short and mid-term. Sin financiación No data (2016) UEM