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The Mediterranean diet (MD) plays an important role in delaying vascular aging. The main objective of this study was to analyze the association between adherence to the MD and vascular aging estimated with brachial–ankle pulse wave velocity (ba-PWV) in a Spanish population sample and the differences by sex. Methods: Cross-sectional descriptive study. A total of 3437 subjects from the EVA, MARK and EVIDENT studies participated. The ba-PWV was assessed with the Vasera VS-1500® device. Vascular aging was classified as healthy vascular aging (HVA), normal vascular aging (NVA) and early vascular aging (EVA) and adherence to the MD was assessed with the Mediterranean Diet Adherence Screener questionnaire. Results: The mean age was 60.15 ± 9.55 (60.09 ± 9.71 in women; 60.20 ± 9.43 in men). Overall, MD adherence was observed in 48.0% of subjects (40% in women; 54% in men). The mean value of ba-PWV was 14.38 ± 2.71 (women 14.24 ± 2.89; men 14.49 ± 2.56). In multinomial logistic regression a positive association was found overall between HVA and NVA (OR = 1.751, 95% CI: 1.411–2.174, p < 0.001) and between HVA and EVA (OR = 1.501, 95% CI:1.295–1.740, p < 0.001); in women between HVA and NVA (OR = 2. 055, 95% CI:1.456–2.901, p < 0.001) and between HVA and EVA (OR = 1.413, 95% CI:1.124–1.776; p = 0.003); and in men between HVA and NVA (OR = 1.551, 95% CI: 1.175–2.047, p = 0.002) and between HVA and EVA (OR = 1.549, 95% CI: 1.275–1.882; p < 0.001). Conclusions: The results of this work indicate that greater adherence to the MD is associated with healthier vascular aging. [ABSTRACT FROM AUTHOR]

Background: Primary dysmenorrhea is a leading cause of chronic cyclic pelvic pain, contributing to a reduced quality of life and sleep disturbances in women. The objective of this study was to assess the effectiveness of transcutaneous tibial nerve stimulation (TTNS) in improving the quality of life, sleep, and overall health perceptions of participants compared to a control group of women with dysmenorrhea over short-term, medium-term, and long-term periods. Methods: A single-blind, controlled clinical trial was conducted, with participants randomly assigned to an experimental group (receiving TTNS) or a control group (receiving sham TTNS). Both groups underwent 12, weekly 30 min sessions using the NeuroTrac™ PelviTone electrostimulation device. Outcomes related to quality of life, sleep deficiency, and overall improvement were evaluated at three time points: short-term (post-treatment), medium-term (1–3 months), and long-term (6 months). Results: Of the 61 participants initially randomized (31 in the experimental group and 30 in the control group), 55 completed the study and were included in the final analysis. A statistically significant improvement was observed in the experimental group in both physical and mental health components, as measured by the SF-36v2® questionnaire, following 12 weeks of intervention, compared to the control group, persisting 6 months after the intervention. Additionally, statistically significant differences in overall improvement were noted between the two groups, as measured by the PGIC questionnaire at the end of treatment (p = 0.0103) and 6 months post-treatment (p = 0.0432). Conclusions: TTNS appears to be a safe and effective strategy for enhancing quality of life and overall health in women with PD, potentially reducing the reliance on pharmacological treatments or more invasive methods. [ABSTRACT FROM AUTHOR]

Background: Vibration platforms have demonstrated systemic effects generated by the use of mechanical vibrations, which are similar to those of any physical activity. The effect that whole body vibration (WBV) generates on the organism could be recommended in Diabetes Mellitus 2 (DM 2) patients. Objective: To systematically review and meta-analyze the available evidence on the effects of WBV on glycemic control in patients with DM 2 Material and methods: Exhaustive bibliographic searches were carried out until October 2023 in different biomedical portals and databases: Public Medline (PubMed), Scientific Electronic Library Online (SciELO), VHL Regional Portal, Cochrane Central and Latin American and Caribbean Literature in Health Sciences (LILACS). Randomized clinical trials based on the effects of Whole Body Vibration on glycosylated hemoglobin levels, with control group and participants were non-insulin dependent were the inclusion criteria. Two reviewers extracted data independently. A third reviewer was available for discrepancies. Results: Six articles with 223 participants met the criteria and were included in the systematic review; only four of them met the criteria to be part of the metaanalysis. This meta-analysis reveals a positive and significant effect size (m ê =0.5731), indicating a substantial difference between the groups studied. Although there is some variability between studies (heterogeneity of 30.05%), the overall direction of the effects is consistent. These findings conclusively suggest the presence of a significant influence of the variable evaluated, underscoring the robustness and consistency of the relationship observed in the literature reviewed. Conclusion: There are no conclusive results due to the lack of data for some variables, which prevents comparison; but WBV may be an effective therapy to improve glycemic control in DM 2 patients. More studies with more patients and longer follow-up are needed. [ABSTRACT FROM AUTHOR]

(1) The main aim of this study was to analyze the relationship of the Mediterranean diet (MD) with vascular function in participants with and without increased insulin resistance (IR) in the Spanish population. A secondary aim was to study differences by gender. (2) Methods: Data were analyzed from 3401 subjects in the EVA, MARK, and EVIDENT studies (mean age = 60 years and 57% men). IR was evaluated with the triglyceride and glucose index (TyG index). TyG index = Ln [(fasting triglyceride mg/dL × fasting glucose mg/dL)/2]. The MD was measured against the MEDAS questionnaire, with the 14 items used in the PREDIMED study. Vascular stiffness was estimated with the brachial–ankle pulse wave velocity (baPWV) and the cardio ankle vascular index (CAVI) using the Vasera VS-1500®. (3) Results: The mean MEDAS value was 5.82 ± 2.03; (men: 5.66 ± 2.06; women: 6.04 ± 1.99; p < 0.001). MD adherence was 36.8% (men: 34.2%; women: 40.3%; p < 0.001). The mean baPWV value was 14.39 ± 2.78; (men: 14.50 ± 2.65; women: 14.25 ± 2.93; p = 0.005). A baPWV value ≥ 14.5 m/s was found in 43.4% (men: 43.6%; women: 40.0%; p = 0.727). The mean CAVI value was 8.59 ± 1.28; (men: 8.75 ± 1.28; women: 8.37 ± 1.26; p < 0.001). CAVI values ≥ 9 were present in 39.0% (men: 44.4%; women: 31.7%; p < 0.001). The mean value of the TGC/G index was 10.93 ± 1.39; (men: 11.08 ± 1.33; women: 10.73 ± 1.43; p < 0.001). IR was found in 49.9%. The average value of the MD score value was negatively associated with baPWV and CAVI in all groups analyzed (<0.05), except in the group of women with insulin resistance. (4) Conclusions: The results suggest that MD adherence is negatively associated with the vascular stiffness parameters analyzed in all the groups studied except the group of women with insulin resistance. [ABSTRACT FROM AUTHOR]

Primary dysmenorrhea is considered one of the main causes of pelvic pain during a woman's childbearing years, resulting in poor quality of life. The objective was to evaluate the effectiveness of transcutaneous tibial nerve stimulation (TTNS) in painful symptomatology improvement and non-steroidal anti-inflammatory drug (NSAID) intake reduction in women with primary dysmenorrhea (PD) compared with a control group in the short, medium, and long terms. A single-blind, controlled clinical trial was developed. Participants were randomized to the experimental (TTNS) and control group (sham TTNS). Both groups received 12-weekly 30-min sessions with a NeuroTracTM PelviTone electrostimulation device. The intensity and severity of pain and non-steroidal anti-inflammatory drug (NSAID) intake were evaluated in the short-term (after treatment), medium-term (1–3 months), and long-term (6 months). A total of 61 participants were randomized, with a split of 31 (experimental group) and 30 (control group), but 55 participants completed the study and were analyzed. Statistically significant differences between both groups in the maximum pain intensity decrease (F = 4.88, p = 0.0043) measured with the visual analogue scale, as well as NSAID intake decrease (F = 4.68, p = 0.011) and days of their ingestion (F = 4.57, p = 0.012) occurred in the short term. Furthermore, significant decreases in the total number of NSAIDs ingested during the cycle (F = 3.82, p = 0.011) and the number of days on which patients ingested NSAIDs (F = 3.59, p = 0.015) in the medium–long term occurred. TTNS could be an effective and safe strategy to reduce pain caused by PD, which could reduce or complement the use of pharmacological techniques and other more invasive methods. [ABSTRACT FROM AUTHOR]

The aim of this study was to analyze the relationship between healthy vascular aging (HVA) and the Mediterranean diet alongside other lifestyles in a Spanish population aged 35 to 75 years without previous cardiovascular diseases. Methods: In this cross-sectional descriptive study, 501 individuals aged 35 to 75 years were recruited from five health centers by random sampling stratified by age and sex (55.90 ± 14.24 years, 49.70% men). HVA was determined in two steps. Step 1: Subjects with vascular damage to the carotid arteries or peripheral arterial disease were classified as non-HVA. Step 2: The study population was classified by age and sex using the percentiles of the vascular aging index (VAI), with VAI ≤p25 considered HVA and >p25 considered non-HVA. The VAI was estimated using the following formula (VAI = (log (1.09) × 10 cIMT + log (1.14) cfPWV) × 39.1 + 4.76. Carotid–femoral pulse wave velocity (cfPWV) was measured with the SphygmoCor® device, and carotid intima–media thickness using Sonosite Micromax® ultrasound. Mediterranean diet (MD) adherence, alcohol and tobacco use were recorded through validated questionnaires. Physical activity was assessed with the ActiGraph-GT3X® accelerometer. Results: The mean VAI value was 61.23 ± 12.86 (men—63.47 ± 13.75 and women—59.04 ± 11.54; p < 0.001). HVA was found in 18.9% (men—19.9% and women—17.8%). In the multiple regression analysis after adjusting for possible confounding factors, the mean VAI value showed a positive association with alcohol use (β = 0.020) and sedentary hours per week (β = 0.109) and a negative association with hours of activity per week (β = −0.102) and with the number of healthy lifestyles (β = −0.640). In the logistic regression analysis, after adjusting for possible confounding factors and compared to those classified as non-HVA, subjects classified as HVA were more likely to show MD adherence (OR = 0.571), do more than 26 h per week of physical activity (OR = 1.735), spend under 142 h per week being sedentary (OR = 1.696), and have more than two healthy lifestyles (OR = 1.877). Conclusion: The results of this study suggest that the more time spent doing physical activity and the less time spent in a sedentary state, the lower the vascular aging index and the greater the likelihood of being classified in the group of subjects with HVA. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

Primary dysmenorrhea (PD) is a painful menstruation that can persist for the duration of a woman's fertile life. Non-steroidal anti-inflammatory drugs, hormonal therapy, physiotherapy techniques, etc., are the main treatments. The main objective of this study is to evaluate the effectiveness of transcutaneous posterior tibial nerve stimulation (TTNS) in PD patients. The study will consist of a single-blind randomized clinical trial, parallel-assigned with two arms. Women with PD (18–43 years) with regular menstrual cycles and at least 4 points in VAS will be randomly divided into experimental (TTNS) and placebo (simulated stimulation) groups during 12 treatment sessions (1 session/week) and several follow-ups: monthly during treatment and 1, 3 and 6 months after. Maximum and mean pain intensity, pain duration, pain severity, number of anti-inflammatory drugs, quality of life, sleep quality, overall improvement, treatment satisfaction and secondary effects will be measured once a month every 6 months and at 3 and 6 months. The Student's t-test for independent samples or the Mann–Whitney U test will be used. The literature shows effective physiotherapeutic techniques for PD in the short term, which do not act on causes and have limitations. The TTNS technique can be used in transcutaneous and percutaneous modalities, with similar effectiveness, but the transcutaneous causes less discomfort. TTNS modulates pain, and long-term benefits could be achieved at low cost and without patient discomfort. [ABSTRACT FROM AUTHOR]

CrossFit® Training is a physical and sports-conditioning system based on constantly varied functional movements performed at high intensity. CrossFit® has been shown to significantly improve general physical performance and body composition. Although there seems to be an association between the practice of CrossFit® and musculoskeletal injuries, the relationship between CrossFit® and injury risks has been poorly studied. The main objective of this study was to establish the relationship between CrossFit® and musculoskeletal injuries. Secondary objectives were the analysis of various risk factors and injury and the comparison of the incidence of CrossFit® injuries to that of other sports. An online questionnaire was distributed to gyms affiliated with CrossFit®, Inc. in the Principality of Asturias, Spain in order to carry out a retrospective transversal descriptive study. The frequency of injuries in CrossFit® is similar to most sports. Injuries are often minor and of short duration, with the shoulder being the most affected joint complex. [ABSTRACT FROM AUTHOR]

Introduction: Fibromyalgia, a musculoskeletal ailment of unknown origin, profoundly affects quality of life. Emerging bioelectrical stimulation techniques, including transcranial magnetic stimulation (TMS), transcranial direct current stimulation (tDCS), and pulsed low-frequency magnetic field stimulation (PEMF), show promise in short-term pain alleviation. This study aimed to rigorously evaluate the effectiveness and safety of these techniques in treating fibromyalgia. Methods: A systematic review (SR) of available literature on the effectiveness and safety of bioelectrical stimulation techniques was carried out according to the Cochrane Collaboration methodology and PRISMA reporting guideline. Evaluated studies included SRs (with or without meta-analyses) and randomized controlled trials (RCTs) published after the SRs. SRs were appraised with the AMSTAR-2 tool and RCTs were assessed with version two of the Cochrane Collaboration risk-of-bias tool for randomized trials. The findings were synthesized narratively. In the absence of SRs with meta-analyses for specific techniques, we conducted a meta-analysis for each available outcome measure, including pain, fatigue, symptom severity, quality of life, anxiety, and depression. Results: Seven SRs incorporating 35 RCTs were included. Two SRs evaluated TMS effectiveness, while five focused on tDCS. Additionally, 17 RCTs were included: two on repetitive TMS, six on tDCS, and eight on PEMF (three assessing targeted PEMF). General confidence in the SR results varied, with most having critically low confidence. Three additional RCTs were rated as low risk of bias, seven were rated as unclear risk of bias, and the remaining seven were rated as high risk of bias. A meta-analysis covered additional RCTs on PEMF and assessed pain intensity, symptom severity, general health-related quality of life, and fibromyalgia-related quality of life. Conclusions: Overall, the results suggest that repetitive TMS, tDCS, and PEMF could improve pain and quality of life in patients with fibromyalgia. It is, however, necessary to conduct high quality studies to demonstrate the clinical relevance of these effects. While the techniques evaluated appear to be safe, mild adverse effects involving the area of stimulation may occur. [ABSTRACT FROM AUTHOR]

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A letter to the editor is presented in response to an article on the differences in the short-term outcomes between trigger point dry needling and trigger point manual therapy for chronic mechanical neck pain by R. Llamas-Ramos and colleagues in the November 2014 issue.

BackgroundObjectiveMethodsResultsConclusionsParkinson’s Disease (PD) is a neurodegenerative disease that produces balance and gait disorders. Action observation (AO) and motor imagery (MI) therapies appear to facilitate motor planning influencing balance and gait relearning.To investigate the effectiveness of AO and MI in isolation or combined (AO-MI), compared to sham interventions for the improvement of freezing of gait (FOG), speed, physical function and balance among individuals with PD.PubMed, Web of science, PEDro, Scopus and Cochrane Library were searched from inception to January 2024. Studies included were randomized controlled trials (RCTs). The study quality and risk of bias were assessed with PEDro scale and the Cochrane tool, respectively. The certainty of evidence was evaluated with GRADEpro GDT.Eight RCTs were included, with a methodological quality ranged from fair to high. There were statistically significant results in FOG at follow-up when comparing AO to sham intervention (SMD= −0.50, 95% CI −0.88, −0.11; I2: 0%) 3 studies, 107 participants). Interventions based on MI compared to sham intervention were statistically significant in speed at post-treatment (MD = −0.06, 95% CI −0.04, −0.08; I2: 0%) and balance at post-treatment (SMD = -0.97; 95% CI −1.79, −0.15).Very low certainty of evidence was found proposing that: AO produce improvements in FOG at follow-up; and MI produce improvements in speed and balance at post-treatment. [ABSTRACT FROM AUTHOR]