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1. Prediction models of health-related quality of life in different neck pain conditions: a cross-sectional study

Author

Beltran-Alacreu H, López-de-Uralde-Villanueva I, Calvo-Lobo C, La Touche R, Cano-de-la-Cuerda R, Gil-Martínez A, Fernández-Ayuso D, and Fernández-Carnero J

Subjects
Quality of Life, Neck Pain, Disability, Depression, Anxiety., Medicine (General), R5-920
Abstract

Hector Beltran-Alacreu,1,2 Ibai López-de-Uralde-Villanueva,1,2 César Calvo-Lobo,3 Roy La Touche,1,2,4 Roberto Cano-de-la-Cuerda,5 Alfonso Gil-Martínez,1,2,4 David Fernández-Ayuso,6 Josué Fernández-Carnero2,4,5 1Departamento de Fisioterapia, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Spain; 2Motion in Brains Research Group, Institute of Neuroscience and Movement Sciences (INCIMOV), Centro Superior de Estudios Universitarios La Salle, Universidad Autonóma de Madrid, Spain; 3Nursing and Physical Therapy Department, Institute of Biomedicine (IBIOMED), Faculty of Health Sciences, Universidad de León, Ponferrada, León, Spain; 4Hospital La Paz Institute for Health Research, IdiPAZ, Madrid, Spain; 5Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos, Alcorcón, Madrid, Spain; 6“San Juan de Dios” School of Nursing and Physiotherapy, Pontifica de Comillas University, Madrid, Spain Purpose: The main aim of the study was to predict the health-related quality of life (HRQoL) based on physical, functional, and psychological measures in patients with different types of neck pain (NP). Materials and methods: This cross-sectional study included 202 patients from a primary health center and the physiotherapy outpatient department of a hospital. Patients were divided into four groups according to their NP characteristics: chronic (CNP), acute whiplash (WHIP), chronic NP associated with temporomandibular dysfunction (NP-TMD), or chronic NP associated with chronic primary headache (NP-PH). The following measures were performed: Short Form-12 Health Survey (SF-12), Neck Disability Index (NDI), visual analog scale (VAS), State-Trait Anxiety Inventory (STAI), Beck Depression Inventory (BECK), and cervical range of movement (CROM). Results: The regression models based on the SF-12 total HRQoL for CNP and NP-TMD groups showed that only NDI was a significant predictor of the worst HRQoL (48.9% and 48.4% of the variance, respectively). In the WHIP group, the regression model showed that BECK was the only significant predictor variable for the worst HRQoL (31.7% of the variance). Finally, in the NP-PH group, the regression showed that the BECK, STAI, and VAS model predicted the worst HRQoL (75.1% of the variance). Conclusion: Chronic nonspecific NP and chronic NP associated with temporomandibular dysfunction were the main predictors of neck disability. In addition, depression, anxiety, and pain were the main predictors of WHIP or primary headache associated with CNP. Keywords: quality of life, neck pain, disability, depression, anxiety

Published
2018

2. Management of pain in patients with temporomandibular disorder (TMD): challenges and solutions

Author

Gil-Martínez A, Paris-Alemany A, López-de-Uralde-Villanueva I, and La Touche R

Subjects
biobehavioral, management, pain, review, temporomandibular disorders., Medicine (General), R5-920
Abstract

Alfonso Gil-Martínez,1–3 Alba Paris-Alemany,1–4 Ibai López-de-Uralde-Villanueva,1–3 Roy La Touche1–4 1Department of Physiotherapy, 2Motion in Brains Research Group, Instituto de Neurociencias y Ciencias del Movimiento, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, 3Hospital La Paz Institute for Health Research, IdiPAZ, 4Institute of Neuroscience and Craniofacial Pain (INDCRAN), Madrid, Spain Abstract: Thanks to advances in neuroscience, biopsychosocial models for diagnostics and treatment (including physical, psychological, and pharmacological therapies) currently have more clinical support and scientific growth. At present, a conservative treatment approach prevails over surgery, given it is less aggressive and usually results in satisfactory clinical outcomes in mild–moderate temporomandibular disorder (TMD). The aim of this review is to evaluate the recent evidence, identify challenges, and propose solutions from a clinical point of view for patients with craniofacial pain and TMD. The treatment we propose is structured in a multimodal approach based on a biobehavioral approach that includes medical, physiotherapeutic, psychological, and dental treatments. We also propose a new biobehavioral model regarding pain perception and motor behavior for the diagnosis and treatment of patients with painful TMD. Keywords: biobehavioral, review, temporomandibular disorders, biobehavioral orofacial pain, multimodal approach, motor behavior, disability

Published
2018

3. Relationships between craniocervical posture and pain-related disability in patients with cervico-craniofacial pain

Author

López-de-Uralde-Villanueva I, Beltran-Alacreu H, Paris-Alemany A, Angulo-Díaz-Parreño S, and La Touche R

Subjects
Medicine (General), R5-920
Abstract

Ibai López-de-Uralde-Villanueva,1–4 Hector Beltran-Alacreu,1–3 Alba Paris-Alemany,1–4 Santiago Angulo-Díaz-Parreño,2,3,5 Roy La Touche1–4 1Department of Physiotherapy, Faculty of Health Science, 2Research Group on Movement and Behavioral Science and Study of Pain, The Center for Advanced Studies University La Salle, Universidad Autónoma de Madrid, Aravaca, Madrid, Spain; 3Institute of Neuroscience and Craniofacial Pain (INDCRAN), Madrid, Spain; 4Hospital La Paz Institute for Health Research, IdiPAZ, Madrid, Spain; 5Faculty of Medicine, Universidad San Pablo CEU, Madrid, Spain Objectives: This cross-sectional correlation study explored the relationships between craniocervical posture and pain-related disability in patients with chronic cervico-craniofacial pain (CCFP). Moreover, we investigated the test–retest intrarater reliability of two craniocervical posture measurements: head posture (HP) and the sternomental distance (SMD). Methods: Fifty-three asymptomatic subjects and 60 CCFP patients were recruited. One rater measured HP and the SMD using a cervical range of motion device and a digital caliper, respectively. The Spanish versions of the neck disability index and the craniofacial pain and disability inventory were used to assess pain-related disability (neck disability and craniofacial disability, respectively). Results: We found no statistically significant correlations between craniocervical posture and pain-related disability variables (HP and neck disability [r=0.105; P>0.05]; HP and craniofacial disability [r=0.132; P>0.05]; SMD and neck disability [r=0.126; P>0.05]; SMD and craniofacial disability [r=0.195; P>0.05]). A moderate positive correlation was observed between HP and SMD for both groups (asymptomatic subjects, r=0.447; CCFP patients, r=0.52). Neck disability was strongly positively correlated with craniofacial disability (r=0.79; P>0.001). The test–retest intrarater reliability of the HP measurement was high for asymptomatic subjects and CCFP patients (intraclass correlation coefficients =0.93 and 0.81, respectively) and for SMD (intraclass correlation coefficient range between 0.76 and 0.99); the test–retest intrarater reliability remained high when evaluated 9 days later. The HP standard error of measurement range was 0.54–0.75 cm, and the minimal detectable change was 1.27–1.74 cm. The SMD standard error of measurement was 2.75–6.24 mm, and the minimal detectable change was 6.42–14.55 mm. Independent t-tests showed statistically significant differences between the asymptomatic individuals and CCFP patients for measures of craniocervical posture, but these differences were very small (mean difference =1.44 cm for HP; 6.24 mm for SMD). The effect sizes reached by these values were estimated to be small for SMD (d=0.38) and medium for HP (d=0.76). Conclusion: The results showed no statistically significant correlations between craniocervical posture and variables of pain-related disability, but a strong correlation between the two variables of disability was found. Our findings suggest that small differences between CCFP patients and asymptomatic subjects exist with respect to the two measurements used to assess craniocervical posture (HP and SMD), and these measures demonstrated high test–retest intrarater reliability for both CCFP patients and asymptomatic subjects. Keywords: measurement, neck pain, rehabilitation, reliability, reproducibility of results, temporomandibular disorders

Published
2015

10. Sobre el Concepto de Ejercicio Terapéutico: La identidad profesional y la organización de la Fisioterapia

Author

La Touche, R., Paris Alemany, Alba, La Touche, R., and Paris Alemany, Alba

Abstract

This manuscript emphasizes the critical role of therapeutic exercise in physical therapy, outlining its historical evolution and proposing considerations for enhancing its implementation in clinical practice, academia, and organizational management. The text highlights historical figures such as Per Henrik Ling, a pioneer of therapeutic exercise in the 19th century and founder of the Royal Central Institute of Gymnastics in Stockholm, a precursor of modern physiotherapy, and Mary McMillan, the founder of the first school of physical therapy in the UnitedStates and author of the first physiotherapy text in the U.S., who explicitly introduced the concept of therapeutic exercise.The manuscript defines therapeutic exercise as a broad range of movement-based procedures, used to decrease disability and enhance functional capacity and physical fitness. It can be applied in the prevention and recovery processes of various conditions, encompassing neurological, cardiorespiratory, and musculoskeletal ailments. Professional skills in physiotherapy derive from the ability to diagnose, evaluate, and advise patients, implement treatments centered on manual therapy and therapeutic exercise, and employ knowledge based on scientific evidence. Historically, the use of exercise has emerged as one of the therapeutic pillarsof physical therapy. However, it is noted that in Spain, the concepts and applications of exercise prescription are not yet fully integrated into academia and clinical practice. The manuscript proposes that it is crucial to acknowledge these deficienciesto consolidate, integrate, and protect competencies related to therapeutic exercise prescription. It suggests that it is necessary to increase the proportion of credits related to therapeutic exercise prescription in the physiotherapy degree curriculum and includes other recommendations to improve the implementation of therapeutic exercise from clinical, academic, and organizational management perspectives., El presente manuscrito resalta el papel crítico del ejercicio terapéutico en la fisioterapia, delineando su evolución histórica y proponiendo reflexiones para mejorar su implementación en la práctica clínica, la academia y la gestión organizativa. El texto destaca figuras históricas como Per Henrik Ling, pionero del ejercicio terapéutico en el siglo XIX y fundador del Real Instituto Central de Gimnasia en Estocolmo, precursor de la fisioterapia moderna, y Mary McMillan, fundadora de la primera escuela de fisioterapia en Estados Unidos y autora del primer texto de fisioterapia en EE. UU., que introdujo explícitamente el concepto de ejercicio terapéutico.El ejercicio terapéuticose definecomo una amplia gama de procedimientos basados en el movimiento, utilizados para reducir la discapacidad y mejorar la capacidad funcional y aptitud física. Este se puede aplicar en procesos de prevención y recuperación de diversas condiciones, que abarcan afecciones neurológicas, cardiorrespiratorias y musculoesqueléticas.Las habilidades profesionales en fisioterapia provienen de la capacidad para diagnosticar, evaluar y asesorar a los pacientes, implementar tratamientos centrados en la terapia manual y el ejercicio terapéutico, y emplear conocimientos basados en la evidencia científica. Históricamente, el uso del ejercicio se ha erigido como uno de los pilares terapéuticos de la fisioterapia. Sin embargo, se observa que en España los conceptos y aplicaciones de la prescripción de ejercicio aún no están completamente integrados en la academia y la práctica clínica. El manuscrito propone que es crucial reconocer estas deficiencias para consolidar, integrar y proteger las competencias relacionadas con la prescripción de ejercicio terapéutico. Sugiere que es necesario incrementar la proporción de créditos relacionados con la prescripción de ejercicio terapéutico en el currículo del grado de fisioterapia y se incluyen otras recomendaciones para mejorar la implementación del ejercicio terap

Published
2023

11. Analysis of the Verbal Behaviour of the Physiotherapist in the First Clinical Session: A Cross-Sectional Study

Author

Pardo, Joaquin, Bielsa López del Castillo, Juan Pablo, Rodríguez García, Santosh Jorge, La Touche, R., Paris Alemany, Alba, Cuenca Martínez, Ferran, Pardo, Joaquin, Bielsa López del Castillo, Juan Pablo, Rodríguez García, Santosh Jorge, La Touche, R., Paris Alemany, Alba, and Cuenca Martínez, Ferran

Abstract

Objective: This paper presents a preliminary study about verbal behaviour of a physiotherapist exploring possibilities of a system of coding verbal behaviour developed before to study verbal behaviour of psychologists Methods: Principal variable verbal behaviour of physiotherapist was coded using Frojan’s the categorization system of the therapist's verbal behaviour (SISC-CVT) that includes several different types of verbal behaviours: discriminative, evocative, reinforcement, punishment, informative, instructional, motivational. Record during a first clinical session of Physical Therapy sample compress seven physiotherapists Results: Regarding inter-rater reliability, Kappa values were modest: very good (1), good (1), moderate (6), weak (7), poor (2). The discriminative category was the most repeated with an average of 71.20 interventions per session, followed by the reinforcement category with an average of 59.05 interventions per session. The less frequency appeared in the results of the evocative category, with an average of 4.4 interventions per session, and of the punitive category, appearing twice for every first 5 clinical sessions Conclusions: This paper presents some preliminary results from a different approach to research verbal behaviour of physiotherapists. Future research need more training of coding to increase reliability. SISC-CVT reveals differences between several physiotherapist We encourage other researchers to continue exploring verbal behaviour of physiotherapists.

Published
2022

16. Introduciendo la dimensión motora dentro de la conceptualización de la experiencia del dolor

Author

La Touche, R. and La Touche, R.

Abstract

En este planteamiento teórico se propone un diseño y re-conceptualización de la experiencia dolorosa manteniendo el enfoque multidimensional, pero introduciendo una dimensión más, que se denomina “comportamiento motor”.La dimensión del comportamiento motor incluye todas los procesos y respuestas asociadas a la experiencia dolorosa que pueden manifestarse de forma adaptativa o desadaptativa y que influyen de forma directa sobre el procesamiento y la modulación del dolor y además interactúan de forma circundante con los procesos afectivos-motivacionales, los sensoriales y los cognitivos.

Published
2021

17. Differences in dynamic and postural stability based on degree of disability in patients with nonspecific chronic lower back pain: an observational study

Author

Grande Alonso, Mónica, Pérez Muñoz, Raquel, Aceña García, José María, Recio Mateo, Francisco Fernando, Pro-Marín, Diego, La Touche, R., Grande Alonso, Mónica, Pérez Muñoz, Raquel, Aceña García, José María, Recio Mateo, Francisco Fernando, Pro-Marín, Diego, and La Touche, R.

Abstract

Objetive: The main objective of this study was to analyze whether there were differences in dynamic balance and postural stability in relation to the level of disability in patients with chronic low back pain. Methodss: This is an observational study in which 60 patients with nonspecific chronic low back pain were included. All patients received a sociodemographic questionnaire, the visual analogue scale (VAS) and a series of self-reported psychological scales. To complete the evaluation, physical tests were performed in which dynamic balance and postural stability were measured. Results: Student’s t-test revealed that there were significant differences between the groups in dynamic balance with the right leg and the left leg. In contrast, there were no significant differences between the groups for the reach functional test in forward direction, left direction and right direction. Conclusion: In conclusion, our study demonstrates that patients with chronic low back pain with high levels of disability present significantly poorer dynamic balance compared with those with low levels of disability. In contrast, no significant differences were found between the groups in terms of static stability.

Published
2021

18. Changes in response time and accuracy of laterality recognition tasks according to the age in healthy subjects: a cross-sectional study

Author

León Hernández, Jose Vicente, Suso Martí, Luís, La Touche, R., Cuenca Martínez, Ferran, León Hernández, Jose Vicente, Suso Martí, Luís, La Touche, R., and Cuenca Martínez, Ferran

Abstract

Objectives: The main objective of this study was to evaluate the laterality recognition of the body parts “hands”, “neck” and “feet” based on the response time and accuracy of left/right body-part judgments with performance compared across three age groups. The secondary objective was to calculate within age correlations between the time and accuracy variables and a measure of physical activity that provides activity in metabolic equivalents [METs]), and the METs score. Methods: A total sample of 154 healthy subjects was divided into three age groups: G1 (n = 58), G2 (n = 38), and G3 (n = 58). Response time and accuracy were measured with the application Recognise designed by the NOI Group for “hand”, “neck” and “feet” images. Results: The results showed significant changes between groups in accuracy and response time for all body parts. Post-hoc analysis revealed longest response time and worst accuracy for G3. In the correlation with METs analysis, the strongest correlations were found in G1, where there was a positive moderate association between the METs score and the accuracy for the right-hand images (r = 0.352) and right neck images (r = 0.398). Conclusion: Body-part laterality recognition is altered with age. Longer response time and lower accuracy was observed for “hands”, “neck” and “feet”.

Published
2021

20. Development and Validation of the AdT-Physio Scale: A Tool to Assess Adherence and Perception of Physical Therapist Intervention in Patients With Cystic Fibrosis

Author

Del Corral T, La Touche R, Cebrià I Iranzo MÀ, Olmos R, Blanco-Royano F, and López-de-Uralde-Villanueva I

Subjects
Cystic Fibrosis, Measures, Physical Therapy, Treatment Adherence and Compliance
Abstract

The purpose of this study was to develop a scale to measure patient adherence to physical therapist intervention and to report psychometric properties in patients with cystic fibrosis (CF).

Published
2020

21. Prescripción de ejercicio terapéutico en Fisioterapia. Las bases elementales de la identidad profesional.

Author

La Touche, R. and La Touche, R.

Abstract

Históricamente la concepción profesional de la fisioterapia se asienta a través de la utilización de la terapia manual y ejercicio como medios terapéuticos principales para recuperar a pacientes con diversos trastornos (Hansson & Ottosson, 2015; Shaik & Maniyat Shemjaz, 2014). Los términos movimiento y ejercicio están directamente relacionados con la génesis y evolución de la fisioterapia. Algunos autores sugieren que la construcción central del cuerpo del conocimiento de la fisioterapia es el sistema de movimiento humano (Coffin-Zadai, 2007; Sahrmann, 2014; Voight & Hoogenboom, 2017), este sistema se define como “la integración de sistemas corporales que generan y mantienen el movimiento en todos los niveles de la función corporal y está influenciado por factores sociales, ambientales y personales”(American Physical Therapy Association, 2015).

Published
2020

22. Métodos de representación del movimiento en rehabilitación. Construyendo un marco conceptual para la aplicación en clínica

Author

La Touche, R. and La Touche, R.

Abstract

Dentro de los métodos utilizados para mejorar el aprendizaje motor y la recuperación funcional se encuentran los tratamientos o entrenamientos cuyos mecanismos están directamente relacionados con el sistema nervioso centraly,además,presentan una alta demanda cognitiva e intentan mejorar la integración sensoriomotora a partirde la construcción de una representación mental del movimiento. Estos métodos han sido denominados de diversas formas tales como métodos de entrenamiento cerebral o técnicas de práctica mental. Apesar de que estos términos están muy integrados en el léxico popular de las ciencias aplicadas a la rehabilitación, considero que es necesario realizar una mejor conceptualización, y el denominativo “métodosde representación del movimiento (MRM)” conjuga y representa muy bien las bases neurofisiológicas y prácticas de estos tratamientos.

Published
2020

23. The influence of the intervention time on the motor learning process induced through movement representation techniques: a randomized controlled pilot trial

Author

Hera Robledo, Nahia de la, Castro Puerta, Miguel, Cuenca Martínez, Ferran, La Touche, R., Hera Robledo, Nahia de la, Castro Puerta, Miguel, Cuenca Martínez, Ferran, and La Touche, R.

Abstract

Objective: The main aim was to assess motor learning process comparing action observation (AO), motor imagery (MI), and double time of MI (2MI) at post- and at 1-week post-intervention through Purdue-Pegboard test. The secondary objectives were to assess if improvements enhanced the ability to imagine and the perceived fatigue. Methods: 20 healthy subjects were randomly assigned to AO group, MI group, 2MI group or placebo observation group. Results: Results in right hand test showed that AO group obtained improvements at post- and at 1-week post-intervention, both with a large effect size (p = .049, d = -1.28 and p = .049, d = -1.4). In left hand test MI group obtained better results than placebo group (p = .016, d = 2.21). In both hand test MI presented differences at the post- and at 1-week post-intervention (p = .006, d = -2.28 and p = .009, d = -1.89). No within- and between-group differences were found in sequence test. With respect to the perceived fatigue, both MI and 2MI showed greater levels of fatigue (p = .003, and p = .045). Finally, no within- and between-group differences were found in the ability to imagine (p > .05). Conclusions: Both movement representation techniques enhanced motor learning, although the results must be considered with caution due to the small sample size. MI seems to cause more fatigue than AO. However, increasing imagery time did not results in greater level of fatigue. The improvements did not lead to an increase in the ability to imagine.

Published
2020

24. Capacidad de generar imágenes mentales motoras en bailarines profesionales y sujetos sedentarios

Author

Agudo Carmona, Diego, Daimiel Yllera, Alicia, Vaz-Torralba, Patricia, Paris Alemany, Alba, Cuenca Martínez, Ferran, La Touche, R., Agudo Carmona, Diego, Daimiel Yllera, Alicia, Vaz-Torralba, Patricia, Paris Alemany, Alba, Cuenca Martínez, Ferran, and La Touche, R.

Abstract

Objetivo: El objetivo principal del presente estudio fue evaluar la capacidad de generar imágenes mentales motoras entre bailarines profesionales y sujetos sedentarios. El objetivo secundario fue evaluar la relación entre la capacidad de generar imágenes mentales motoras y la cronometría mental. Diseño: Estudio observacional transversal. Marco: Conservatorio Superior de Danza. Participantes: 60 participantes fueron divididos en dos grupos: bailarines profesionales (GB) (n = 30) y sujetos sedentarios (GC) (n = 30). Variables: La capacidad de generar imágenes mentales motoras se evaluó a través del cuestionario de imagen del movimiento (MIQ-R) así como de la cronometría mental. El nivel de actividad física se evaluó a través del cuestionario internacional de actividad física (IPAQ). Resultados: En relación con la capacidad de generar imágenes mentales motoras, se encontraron diferencias significativas inter-grupo en todas las variables analizadas (p < .05). Adicionalmente, las correlaciones más fuertes se encontraron en el GB, donde se halló una asociación negativa moderada entre la capacidad de generar imágenes mentales motoras y la cronometría mental (r = -.54). Conclusión: En base a los resultados obtenidos, se sugiere que los bailarines profesionales, presentan una mayor capacidad de generar imágenes mentales motoras que los sujetos sedentarios, empleando, además, un menor tiempo en el desarrollo de la práctica mental.

Published
2020

27. Pensando en Movimiento

Author

La Touche, R. and La Touche, R.

Abstract

Una similitud que existe entre todas las profesiones relacionadas con las ciencias aplicadas a la rehabilitación es la utilización de terapias basadas en el movimiento, estas producen mejoras cognitivas, sensoriales, motoras (La Touche, 2019) y además presentan una gran repercusión sobre el estado de ánimo del paciente (Gourgouvelis et al., 2017). Dentro de las terapias basadas en el movimiento, el ejercicio y su variante específica aplicada a la rehabilitación (ejercicio terapéutico) es la que tiene una gran aplicabilidad clínica, presenta un soporte sólido de la evidencia científica y se prescribe con mayor frecuencia para el tratamiento de trastornos musculoesqueléticos, neurológicos y cardiorrespiratorios (La Touche, 2017). La prescripción de ejercicio terapéutico es un proceso sistemático en el cual se establece un planteamiento terapéutico basado en pruebas físicas y diseñado con el objetivo de recuperar, mejorar, prevenir y optimizar las funciones físicas mediante la utilización de ejercicios con un énfasis rehabilitador (La Touche, 2017).

Published
2019

29. Short-term effects of dry needling of active myofascial trigger points in the masseter muscle in patients with temporomandibular disorders.

Author

Fernández-Carnero J, La Touche R, Ortega-Santiago R, Galan-del-Rio F, Pesquera J, Ge H, and Fernández-de-Las-Peñas C

Abstract

AIMS: To investigate the effects of dry needling over active trigger points (TrPs) in the masseter muscle in patients with temporomandibular disorders (TMD). METHODS: Twelve females, aged 20 to 41 years old (mean = 25, standard deviation +/- 6 years) diagnosed with myofascial TMD were recruited. Each patient attended two treatment sessions on two separate days and received one intervention assigned in a random fashion, at each visit: deep dry needling (experimental) or sham dry needling (placebo) at the most painful point on the masseter muscle TrP. Pressure pain threshold (PPT) over the masseter muscle TrP and the mandibular condyle and pain-free active jaw opening were assessed pre- and 5 minutes postintervention by an examiner blinded to the treatment allocation of the subject. A two-way repeated-measures analysis of variance (ANOVA) with intervention as the between-subjects variable and time as the within-subjects variable was used to examine the effects of the intervention. RESULTS: The ANOVA detected a significant interaction between intervention and time for PPT levels in the masseter muscle (F = 62.5; P < .001) and condyle (F = 50.4; P < .001), and pain-free active mouth opening (F = 34.9; P < .001). Subjects showed greater improvements in all the outcomes when receiving the deep dry needling compared to the sham dry needling (P < .001). CONCLUSION: The application of dry needling into active TrPs in the masseter muscle induced significant increases in PPT levels and maximal jaw opening when compared to the sham dry needling in patients with myofascial TMD. [ABSTRACT FROM AUTHOR]

Published
2010

30. Mobilization versus manipulations versus sustain apophyseal natural glide techniques and interaction with psychological factors for patients with chronic neck pain: Randomized controlled trial

Author

Lopez-Lopez A, Jl, Alonso Perez, Jl, González Gutierez, La Touche R, Sergio Lerma Lara, Izquierdo H, and Fernández-Carnero J

Subjects
Adult, Male, Manipulation, Spinal, Anxiety, Zygapophyseal Joint, Tratamiento médico, Humans, Range of Motion, Articular, Physical Therapy Modalities, Aged, Pain Measurement, Aged, 80 and over, Analysis of Variance, Neck Pain, Depression, Catastrophization, Rehabilitación médica, Middle Aged, Dolor crónico, Musculoskeletal Manipulations, Outcome and Process Assessment, Health Care, Rehabilitación, Spain, Terapia, Cervical Vertebrae, Manipulation, Orthopedic, Female, Chronic Pain
Abstract

BACKGROUND: Three different types of manual therapy techniques for patients with neck pain and relationship with psychological factors has not been evaluated. AIM: To compare the effectiveness high velocity and low amplitude (HVLA) manipulation vs. posteroanterior mobilization (PA mob) vs. sustain appophyseal natural glide (SNAG) in the management of patients with neck pain and to evaluate the interaction with psychological factors. STUDY DESING: Randomized clinical trial. SETTING: Primary Health Care Center. POPULATION: Patients with history of chronic neck pain over the last 3 months were recruited. METHODS: Patients were randomly assigned to receive treatment with HVLA (N.=15), with PA mob (N.=16) or with SNAG (N.=17). One session was applied. Pain intensity of neck pain, pressure pain threshold over processus spinosus of C2 (PPT_C2) and cervical range of motion (CROM) were measured pre- and post-intervention. Pain catastrophizing, depression, anxiety and kinesiophobia were assessed in baseline. ANOVAs were performed, with main effects, two-way (treatment x time) and three-way interactions (treatment x psychological variable x time) were examined. RESULTS: Fourthy-eight patients (mean±SD age, 36.5±8.7 years; 87.5% female). A significant interaction treatment x time was observed for VAS-rest in HVLA and AP mob groups (P

Published
2015

31. Validación y fiabilidad de la versión española de la escala autoadministrada de Evaluación de Signos y Síntomas Neuropáticos de Leeds (S-LANSS)

Author

López-de-Uralde-Villanueva, I., Gil-Martínez, A., Candelas-Fernández, P., de Andrés-Ares, J., Beltrán-Alacreu, H., and La Touche, R.

Abstract

La escala autoadministrada de Evaluación de Signos y Síntomas Neuropáticos de Leeds (S-LANSS) es un instrumento diseñado para identificar a pacientes con dolor de características neuropáticas.

Published
2024
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32. Análisis bioconductual del sistema vestibular y el control postural en pacientes con mareo cervicogénico. Estudio observacional transversal

Author

Grande-Alonso, M., Moral Saiz, B., Mínguez Zuazo, A., Lerma Lara, S., and La Touche, R.

Abstract

El mareo cervicogénico es una afección que se caracteriza por mareos y desequilibrio que se asocia a dolor de cuello. La fisiopatología no está clara, y es necesario conocer la base neurofisiológica del trastorno. El objetivo de estudio es comparar la actividad del reflejo vestíbulo-ocular y el control postural entre pacientes que presentan mareo cervicogénico y sujetos asintomáticos; además, se pretende evaluar la asociación entre la discapacidad por mareo con otras variables psicosociales.

Published
2024
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35. Diagnostico clínico de artrosis en la articulación temporomandibular asociado a un síndrome de dolor miofascial: Análisis de un caso

Author

La Touche, R.

Subjects
Osteoarthrosis, Articulación Temporomandibular, Temporomandibular Joint, Artrosis, Síndrome de Dolor Miofascial, Myofascial Pain Syndrome
Abstract

Se presenta un caso de una paciente de 70 años que presenta dolor orofacial simétrico y dolor local a nivel de la articulación temporomandibular (ATM) derecha. La exploración clínica muestra disminución del rango de movimiento articular, un end feel blando, crepitación a la auscultación, y puntos gatillos miofasciales (PGMs) a nivel de la musculatura masticatoria y del cuello. El estudio radiológico confirma artrosis en la ATM y se termina concluyendo que la sintomatología es provocada, principalmente, por el síndrome de dolor miofascial. Se reafirma la importancia de realizar un diagnóstico diferencial preciso para orientar adecuadamente las pautas del tratamiento. A case report of a 70 year-old patient with bilateral orofacial pain and local pain in the right temporomandibular joint (TMJ). The physical examination shows a decrease in the articular range of motion, a soft end feel, crepitation and trigger points activated at the jaw and neck muscles. The image study confirmed TMJ osteoarthrosis and it was concluded that the symptoms were primarily produced by myofascial pain syndrome. A precise differential diagnoses is important in order to orientate the treatment stages.

Published
2007

36. Influencia de la presión sobre la mucosa gingival en la medición algométrica de un punto gatillo miofascial del músculo masetero: Estudio aleatorio, cruzado, controlado

Author

La Touche, R., Linares, M. T., Angulo, S., and Escalante, K.

Subjects
gingivae mucosa, myofascial trigger point, pressure pain threshold, músculo masetero, algometria, mucosa gingival, masseter muscle, algometry, umbral de dolor a la presión, punto gatillo miofascial
Abstract

Objetivo: Este trabajo valora mediante una aplicación algométrica si la presión sobre la mucosa gingival de la zona de los molares mandibulares influye sobre el umbral del dolor a la presión (UDP) de uno de los puntos gatillo miofasciales (PGMs) del músculo masetero. Material y métodos: Se estudiaron un total de 38 pacientes que presentaban dolor orofacial por PGMs a nivel del músculo masetero. Se valoro el UDP por medio de algometría y la percepción de la intensidad del dolor (PID) post-medición por medio de la Escala Visual Analógica (EVA). Todos los sujetos del estudio se utilizaron como grupo experimental y control; al grupo experimental se la aplicó una medición donde se evitaba generar presión sobre la mucosa gingival y al control una medición directa sobre PGM. El orden de aplicación de las mediciones se realizó por medio de una distribución aleatoria sistemática. Resultados: Se observaron diferencias estadísticamente significativas entre el UDP obtenido en el grupo experimental con respecto al control (P < 0,05). La medición de la PID no presentó diferencias estadísticamente significativas (P > 0,05) y tampoco se apreció una correlación entre el UDP y la PID postmedición para el grupo experimental (r = -0,11, P = 0,5) ni para el caso del grupo control. (r = 0,15, P = 0,36). Conclusiones: Los resultados obtenidos demuestran que el evitar la presión sobre la mucosa gingival si influye en el valor de la medición algométrica, ya que aumenta el UDP de el PGM valorado en el músculo masetero. Sin embargo, es necesario realizar más investigaciones que puedan determinar la sensibilidad y la fiabilidad de este protocolo de medición antes de ser extrapolado a la clínica. Objective: Our study sets out to determine if the pressure on the gingivae mucosa of the lower molars influences the pressure pain threshold of one of the masseter's myofascial trigger point. Material and methods: A total of 38 subjects who had orofacial pain were included in the study. The masseter's myofascial trigger point was studied. The pressure pain threshold (PPT) was measured via algometer and the intensity pain perception post-algometry measurement via Visual Analogical Scale (VAS). All study subjects were regarded either as experimental or as control group. A free-pressure measurement onto the gingivae mucosa was used in the experimental group. Meanwhile, a direct pressure measurement was used in the control group. The sequence of measurements order was carried out by means of a randomized systematical distribution. Results: There were significant statistical differences between the PPT obtained in the experimental group and those of the control group (P0.05). There was no correlation between PPT and pain intensity perception post-algometry measurement in any of the groups (r = 0.13 , P = 0.5 for the experimental group; r = 0.5 , P = 0.36). Conclusión: According to our study results, the observation shows that no pressure onto the gingivae mucosa influences in algometry measurements producing an increase in PPT valúes of the masseter's myofascial trigger point. Nevertheless, further investigation is required on the sensitivity and reliability of this protocol measurement before clinical use.

Published
2007

37. Influencia de la presión sobre la mucosa gingival en la medición algométrica de un punto gatillo miofascial del músculo masetero: Estudio aleatorio, cruzado, controlado

Author

La Touche,R., Linares,M. T., Angulo,S., and Escalante,K.

Subjects
músculo masetero, algometria, mucosa gingival, umbral de dolor a la presión, punto gatillo miofascial
Abstract

Objetivo: Este trabajo valora mediante una aplicación algométrica si la presión sobre la mucosa gingival de la zona de los molares mandibulares influye sobre el umbral del dolor a la presión (UDP) de uno de los puntos gatillo miofasciales (PGMs) del músculo masetero. Material y métodos: Se estudiaron un total de 38 pacientes que presentaban dolor orofacial por PGMs a nivel del músculo masetero. Se valoro el UDP por medio de algometría y la percepción de la intensidad del dolor (PID) post-medición por medio de la Escala Visual Analógica (EVA). Todos los sujetos del estudio se utilizaron como grupo experimental y control; al grupo experimental se la aplicó una medición donde se evitaba generar presión sobre la mucosa gingival y al control una medición directa sobre PGM. El orden de aplicación de las mediciones se realizó por medio de una distribución aleatoria sistemática. Resultados: Se observaron diferencias estadísticamente significativas entre el UDP obtenido en el grupo experimental con respecto al control (P < 0,05). La medición de la PID no presentó diferencias estadísticamente significativas (P > 0,05) y tampoco se apreció una correlación entre el UDP y la PID postmedición para el grupo experimental (r = -0,11, P = 0,5) ni para el caso del grupo control. (r = 0,15, P = 0,36). Conclusiones: Los resultados obtenidos demuestran que el evitar la presión sobre la mucosa gingival si influye en el valor de la medición algométrica, ya que aumenta el UDP de el PGM valorado en el músculo masetero. Sin embargo, es necesario realizar más investigaciones que puedan determinar la sensibilidad y la fiabilidad de este protocolo de medición antes de ser extrapolado a la clínica.

Published
2007

38. Diagnostico clínico de artrosis en la articulación temporomandibular asociado a un síndrome de dolor miofascial: Análisis de un caso

Author

La Touche,R.

Subjects
Articulación Temporomandibular, Artrosis, Síndrome de Dolor Miofascial
Abstract

Se presenta un caso de una paciente de 70 años que presenta dolor orofacial simétrico y dolor local a nivel de la articulación temporomandibular (ATM) derecha. La exploración clínica muestra disminución del rango de movimiento articular, un end feel blando, crepitación a la auscultación, y puntos gatillos miofasciales (PGMs) a nivel de la musculatura masticatoria y del cuello. El estudio radiológico confirma artrosis en la ATM y se termina concluyendo que la sintomatología es provocada, principalmente, por el síndrome de dolor miofascial. Se reafirma la importancia de realizar un diagnóstico diferencial preciso para orientar adecuadamente las pautas del tratamiento.

Published
2007

43. Craniofacial pain and disability inventory (CF-PDI): Development and psychometric validation of a new questionnaire

Author

Lara-Lara M, Juan C. Suárez-Falcón, La Touche R, Alfonso Gil-Martínez, Santiago Angulo-Díaz-Parreño, Josué Fernández-Carnero, Alba Paris-Alemany, and Joaquín Pardo-Montero

Subjects
Adult, Male, medicine.medical_specialty, Orofacial pain, Psychometrics, Intraclass correlation, Visual analogue scale, Statistics as Topic, Observation, Disability Evaluation, Young Adult, Cronbach's alpha, Facial Pain, Surveys and Questionnaires, medicine, Humans, Longitudinal Studies, Pain Measurement, Neck pain, Analysis of Variance, business.industry, Reproducibility of Results, Middle Aged, Anesthesiology and Pain Medicine, Cross-Sectional Studies, Convergent validity, Spain, Physical therapy, Pain catastrophizing, Female, medicine.symptom, business, Cognition Disorders
Abstract

Background: Orofacial pain, headaches, and neck pain are very common pain conditions in the general population and might be associated in their pathophysiology, although this is not yet clarified. The development and validation of a prediction inventory is important to minimize risks. Most recent questionnaires have not focused on pain, but pain is the common symptom in temporomandibular disorders, headaches, and neck pain. It is necessary to provide tools for these conditions. Objectives: The purpose of this study is to present the development and analysis of the factorial structure and psychometric properties of a new self-administered questionnaire (Craniofacial Pain and Disability Inventory [CF-PDI]) designed to measure pain, disability, and functional status of the mandibular and craniofacial regions. Study Design: Multicenter, prospective, cross-sectional, descriptive survey design. A secondary analysis of the reliability of the measures was a longitudinal, observational study. Setting: A convenience sample was recruited from a hospital and 2 specialty clinics in Madrid, Spain. Methods: The study sample consisted of 192 heterogeneous chronic craniofacial pain patients. A sub-sample of 106 patients was asked to answer the questionnaire a second time, to assess the test-retest reliability. The development and validation of the CF-PDI were conducted using the standard methodology, which included item development, cognitive debriefing, and psychometric validation. The questionnaire was assessed for the following psychometric properties: internal consistency (Cronbach’s α); floor and ceiling effects; testretest reliability (Intraclass Correlation Coefficient [ICC]; Bland and Altman method); construct validity (exploratory factor analysis); responsiveness (standard error of measurement [SEM] and minimal detectable change [MDC]); and convergent validity (Pearson correlation coefficient), by comparing visual analog scale (VAS), the Tampa Scale for Kinesiophobia (TSK-11), the Pain Catastrophizing Scale (PCS), the Neck Disability Index (NDI), and the Headache Impact Test-6 (HIT-6). Multiple linear regression analysis was used to estimate the strength of the associations with theoretically similar constructs. Results: The final version of the CF-PDI consists of 21 items. Exploratory factor analysis revealed 2 factors (“pain and disability” and “jaw functional status”), both with an eigenvalue greater than one, explaining 44.77% of the variance. Floor or ceiling effects were not observed. High internal consistency of the CF-PDI (Cronbach’s α: 0.88) and also of the 2 subscales (Cronbach’s α: 0.80 – 0.86) was confirmed. ICC was found to be 0.90 (95% confidence interval [CI] 0.86 – 0.93), which was considered to be excellent test-retest reliability. The SEM and MDC were 2.4 and 7 points, respectively. The total CF-PDI score showed a moderate correlation with most of the assessed questionnaires (r = 0.36 – 0.52) and a strong correlation with the NDI (r = 0.65; P < 0.001). The NDI, VAS, and TSK-11 were predictors of CF-PDI. Limitations: Only self-reported measures were considered for convergent validity. Future research should use physical tests to explore the clinical signs relating to pain and disability. Conclusion: The CF-PDI showed good psychometric properties. Based on the findings of this study, the CF-PDI can be used in research and clinical practice for the assessment of patients with craniofacial pain. Key words: Craniofacial pain, temporomandibular disorders, headache, neck pain, disability, development, questionnaire, reliability, psychometric validation, minimal detectable change

48. How Does Self-Efficacy Influence Pain Perception, Postural Stability and Range of Motion in Individuals with Chronic Low Back Pain?

Author

Mónica Grande-Alonso, Alba Paris-Alemany, La Touche R, and Arnes-Prieto P

Subjects
Adult, Male, medicine.medical_specialty, Summation, Disability Evaluation, Lumbar, Physical medicine and rehabilitation, Surveys and Questionnaires, Postural Balance, Humans, Medicine, Pain perception, Range of Motion, Articular, Self-efficacy, business.industry, Catastrophization, Chronic pain, Pain Perception, Middle Aged, medicine.disease, Low back pain, Self Efficacy, Chronic low back pain, Anesthesiology and Pain Medicine, Cross-Sectional Studies, Rumination, Postural stability, Physical therapy, Pain catastrophizing, Female, medicine.symptom, business, Range of motion, Low Back Pain
Abstract

Background: Low back pain (LBP) is the most prevalent musculoskeletal problem among adults. Individuals with chronic LBP (CLBP) can present a psychological disorder and a lack of pain self-efficacy. Objectives: The objective of this study was to compare the process of repetition-induced summation of activity-related pain, the lumbar range of motion, and the postural stability of patients with non-specific LBP (NSLBP) based on their level of self-efficacy. Study Design: This research used a descriptive, cross-sectional study design. Methods: This research included 60 patients with NSCLBP. Patients were classified as having “high” or “low” self-efficacy based on a median split of scores on the Chronic Pain Self-Efficacy Scale. All patients received a sociodemographic questionnaire, a psychological self-reported measures (Tampa scale of Kinesiophobia; Pain Catastrophizing Scale; Rumination subscale, Magnification subscale; Helplessness subscale; Roland-Morris Disability Questionnaire; FearAvoidance Belief Questionnaire; Physical Activity subscale; Work subscale); and completed the Temporal Summation Lifting Task, Lumbar Range of Motion, and Multi-Directional Functional Reach Test (MDFRT). Results: The results indicated that the low self-efficacy group had a shorter lumbar range of motion and lower postural stability, in addition to greater pain intensity in the temporal summation lifting task, compared with the high self-efficacy group. The analysis showed that the strongest correlation for the high self-efficacy was between fear of movement and the temporal summation lifting task, and greater scores at the psychological questionnaires, compared with the high selfefficacy group (r = 0.711; P < 0.01). The strongest correlations found for the low self-efficacy group, showed a positive relationship between pain catastrophizing and the temporal summation lifting task (r = 0.765; P < 0.01), and a strong negative association between pain catastrophizing for the magnification subscale and lumbar range of motion (r = -0.759; P < 0.01). Limitations: The results of this study should be interpreted with caution because of its crosssectional design, and therefore causal relationships cannot be established. A significant limitation of the study is that patients’ physical activity levels were not assessed, which could have influenced their ability to perform motor tasks at the perceived difficulty and fear level. Conclusions: The high self-efficacy group had less pain in the temporal summation lifting task, a greater range of motion, and a greater functional range, in addition to a lower influence of psychological factors. Key words: Low back pain, chronic pain, self-efficacy, temporal summation, range of motion, postural stability, fear of movement, pain catastrophizing, low back disability

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