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Background: Exercise can stress the pelvic floor muscles (PFMs). This study sought to assess the strength of the PFMs according to the level of physical exercise. Methods: An analytical ob servational study was carried out using digital palpation and dynamometry measurements to assess PF strength. Healthy nulliparous women were stratified according to physical exercise (physically active and sedentary) and level of physical exercise (elite, amateur, and sedentary). Results: Fifty four women were analyzed, with a mean age of 25.64 (5.33) years and a BMI of 21.41 (2.96) kg/m2 . Differences in the passive force and strength were observed between both groups of women (p < 0.05), and the strength was around two times higher in physically active women (p < 0.05). The strength was similar between elite female athletes and sedentary women (p > 0.05), but statistical differences were found with amateurs (p < 0.05). The PFM strength (p = 0.019) of elite female athletes (0.34 N) was almost half that of amateurs (0.63 N) and twice as strong as that of sedentary women (0.20 N). However, these differences were not significant using digital palpation (p = 0.398). Conclusions: Women who exercise generally have greater PFM strength than women who do not exercise. Physical exercise could strengthen the PFM; however, the high intensity demanded by high-level sports does not seem to proportionally increase the strength of the PFMs.

La incidencia y los costes de las lesiones traumáticas y de tejidos blandos de mano, muñeca y dedos han aumentado en los últimos años, y los esfuerzos por mejorar su abordaje. Son uno de los tipos de lesión más costosas: un 32% más que las fracturas de miembros inferiores, un 39% más que las de cadera y un 108% más que las lesiones craneoencefálicas. Se claman nuevos métodos para abordar la incidencia y coste crecientes. La OMS dictaminó en 2019 que la necesidad de acceder a servicios de rehabilitación es mucho mayor de lo estimado inicialmente. (1) La telerrehabilitación permite implementar dispositivos de uso doméstico o laboral como herramientas ágiles, accesibles y fáciles para mejorar los resultados en salud y la accesibilidad de los pacientes a la rehabilitación. Esta tesis prueba la efectividad de una intervención de telerrehabilitación basada en dispositivos domésticos como tabletas para evaluar su impacto clínico y económico en la práctica clínica real. Contenido de la investigación El presente trabajo cierra una línea de investigación con más de 660 pacientes reclutados que tenía como objetivo evaluar la efectividad de una intervención de telerrehabilitación utilizada tanto como complemento de la terapia presencial y como única intervención domiciliaria. Ensayos clínicos aleatorizados previos (ECA) han demostrado el uso de la intervención de telerrehabilitación estudiada en combinación con sesiones presenciales de fisioterapia y terapia ocupacional acelera la recuperación reduciendo los días de vuelta al trabajo, reduce el uso de asistencia sanitaria y mejora la recuperación de la fuerza y la función en mutualidad laboral.(2) El presente trabajo complementa ya que se trata de un diseño de ensayo pragmático para evidenciar la aplicación en el mundo real de la intervención de telerrehabilitación basada en dispositivos domésticos como tabletas y su efectividad tanto clínica como económica. Conclusión La intervención de estudio como única intervención domicili

Objective The aim of this systematic review is to study the subdiaphragmatic anatomy of the phrenic nerve. Materials and methods A computerised systematic search of the Web of Science database was conducted. The key terms used were phrenic nerve, subdiaphragmat*, esophag*, liver, stomach, pancre*, duoden*, intestin*, bowel, gangli*, biliar*, Oddi, gallbladder, peritone*, spleen, splenic, hepat*, Glisson, falciform, coronary ligament, kidney, suprarenal, and adrenal. The ‘cited-by’ articles were also reviewed to ensure that all appropriate studies were included. Results A total of one thousand three hundred and thirty articles were found, of which eighteen met the inclusion and exclusion criteria. The Quality Appraisal for Cadaveric Studies scale revealed substantial to excellent methodological quality of human studies, while a modified version of the Systematic Review Centre for Laboratory Animal Experimentation Risk of Bias Tool denoted poor methodological quality of animal studies. According to human studies, phrenic supply has been demonstrated for the gastro-esophageal junction, stomach, celiac ganglia, liver and its coronary ligament, inferior vena cava, gallbladder and adrenal glands, with half of the human samples studied presenting phrenic nerve connections with any subdiaphragmatic structure. Conclusions This review provides the first systematic evidence of subdiaphragmatic phrenic nerve supply and connections. This is of interest to professionals who care for people suffering from neck and shoulder pain, as well as patients with peridiaphragmatic disorders or hiccups. However, there are controversies about the autonomic or sensory nature of this supply.

(1) Background: Infantile colic (IC) is a functional gastrointestinal disorder that affects around 20% of infants, and postpartum (PPD) depression is a common disorder that affects between 15 and 22% of mothers. In this study, our objective was to evaluate the relationship between the maternal psychological state in the first postpartum year and IC, with the aim of assessing the importance of feeding type in infants and maternal well-being. (2) Methods: A cross-sectional study was conducted in women in their first year postpartum. Demographic, medical, and obstetric data of the mothers and infants were collected, and the type of feeding was identified. The emotional status of the mother was evaluated using the Edinburgh Postnatal Depression Scale (EPDS), and the Infant Colic Severity Questionnaire (ICSQ) was used for IC diagnosis. (3) Results: A total of 528 women were analyzed, of which 170 (32%) were diagnosed with possible PPD. Two-thirds of the women without depression breastfed their babies on demand; therefore, we report that exclusive breastfeeding (EBF) appears to reduce the risk of possible PPD (p < 0.001; OR = 2.353). IC was present in 39% of babies, and around 70% of babies without colic were breastfed on demand. Infants who were not exclusively breastfed showed almost double the risk of developing colic (p = 0.016; OR = 1.577). There was a significant association between the EPDS and ICSQ scores (p < 0.001). More than half of the women with PPD had babies with colic. However, our results show that 75% of babies without colic had mothers who reported optimal postpartum emotional well-being (p < 0.001; OR = 2.105). (4) Conclusions: The results of this study suggest that postpartum maternal psychological well-being reduces the risk of IC. Therefore, we report that EBF on demand, together with a healthy emotional state in new mothers, may be a protective factor against colic in infants.

Background: Exercise can stress the pelvic floor muscles (PFMs). This study sought to assess the strength of the PFMs according to the level of physical exercise. Methods: An analytical observational study was carried out using digital palpation and dynamometry measurements to assess PF strength. Healthy nulliparous women were stratified according to physical exercise (physically active and sedentary) and level of physical exercise (elite, amateur, and sedentary). Results: Fifty-four women were analyzed, with a mean age of 25.64 (5.33) years and a BMI of 21.41 (2.96) kg/m2. Differences in the passive force and strength were observed between both groups of women (p < 0.05), and the strength was around two times higher in physically active women (p < 0.05). The strength was similar between elite female athletes and sedentary women (p > 0.05), but statistical differences were found with amateurs (p < 0.05). The PFM strength (p = 0.019) of elite female athletes (0.34 N) was almost half that of amateurs (0.63 N) and twice as strong as that of sedentary women (0.20 N). However, these differences were not significant using digital palpation (p = 0.398). Conclusions: Women who exercise generally have greater PFM strength than women who do not exercise. Physical exercise could strengthen the PFM; however, the high intensity demanded by high-level sports does not seem to proportionally increase the strength of the PFMs.

[ES] Introducción: Evaluar si, en pacientes con fractura de extremo distal del radio, los ejercicios domiciliarios realizados en una pantalla táctil de dispositivos tableta reducen el consumo de recursos presenciales y mejoran la recuperación clínica, comparado con el programa convencional de ejercicios domiciliarios prescrito en papel. Material y métodos: Ensayo clínico pragmático, multicéntrico, paralelo, de dos grupos y controlado, con evaluador cegado y análisis por intención de tratar. Reclutados cuarenta y seis pacientes con fractura de extremo distal del radio en dos hospitales del Sistema Sanitario Público de Andalucía (SSPA). Los participantes de los grupos experimental y control recibieron el mismo tratamiento de sesiones presenciales de fisioterapia. El grupo experimental recibió un programa de ejercicios domiciliario utilizando la aplicación para tableta ReHand y el grupo control recibió un programa de ejercicios domiciliario en papel. Variable principal: número de sesiones de fisioterapia registradas en la base de datos electrónica del SSPA. Variables secundarias: número de consultas de rehabilitación presenciales con un médico rehabilitador y variables clínicas como la funcionalidad, la fuerza de prensión, la destreza manual, el dolor y la amplitud de movimiento. Resultados: El grupo experimental necesitó menos sesiones de fisioterapia (DM: −16,94; IC del 95%: −32,5 a −1,38) y consultas de rehabilitación (DM: −1,7; IC del 95%: −3,39 a −0,02) en comparación con el grupo control. Conclusión: En pacientes con fractura de extremo distal del radio, la prescripción de ejercicios realizados en una pantalla táctil de dispositivos tipo tableta a través de ReHand redujo el número de sesiones de fisioterapia y de consultas de rehabilitación., [EN] Introduction: To assess whether, in patients with distal radius fracture feedback-guided exercises performed on a tablet touchscreen reduce healthcare usage and improve clinical recovery, more than the conventional home exercise program prescribed on paper. Material and methods: A multicentre, parallel, two-group, pragmatic, controlled trial with assessor blinding and intention-to-treat analysis. Forty-six patients with distal radius fracture were recruited in Andalusian Public Health System. Participants in the experimental and control groups received the same in-patient physiotherapy sessions. Experimental group received a home exercise program using the ReHand tablet application and control group received an evidence-based home exercise program on paper. The primary outcome was the number of physiotherapy sessions tallied from hospitals data management system. Secondary outcomes included: the face-to-face rehabilitation consultations with a physiatrist, and clinical outcomes such as functional ability, grip strength, dexterity, pain intensity and range of motion. Results: The experimental group required fewer physiotherapy sessions (MD: −16.94; 95% CI: −32.5 to −1.38) and rehabilitation consultations (MD: −1.7; 95% CI: −3.39 to −0.02) compared to the control group. Conclusions: In patients with distal radius fracture, prescribing feedback-guided exercises performed on a tablet touchscreen provided by ReHand reduced number of physiotherapy sessions and rehabilitation consultations.

Neurorehabilitation is a rapidly growing field in motor rehabilitation, which is specifically aimed at restoring neural plasticity of the central nervous system (CNS). The concept of neuroplasticity refers to the ability of the brain to reorganize itself in response to learning or exposure to enriched environments, and it is maintained for the entire human life. Thus, applying specific treatments can be beneficial for people with CNS injuries. The time frame for maximizing the benefits of neuroplasticity is critical, with the plateau observed about 12 weeks after the onset of stroke (1). Thus, it is essential to capitalize on this high level of brain reorganization by providing well-timed and well designed treatments. A range of approaches has been developed for CNS recovery in acute, subacute, or chronic stages of injury. These approaches include priming or augmented techniques, such as end-effector robots, exoskeletons, or virtual reality, with many being confirmed as effective (2, 3). However, clinical practice still lacks specific indications for which therapy is most effective, for how long should be applied, and for which patient impairments. Therefore, this Research Topic aimed to explore new neurorehabilitative ideas and approaches, modifications of already existing techniques, and identification of research or clinical gaps, including predictive research for treatments and recovery.

Objective: To evaluate whether, in patients with trauma and soft tissue injuries of the wrist, hand and/or fingers, an exercise program performed on a touchscreen tablet-based app reduces the consumption of face-to-face resources and improves clinical recovery, compared to a conventional home exercise program prescribed on paper. Design: Pragmatic, multicentre, parallel, two-group, controlled clinical trial with blinded assessor. Participants and setting: Eighty-one patients with traumatic bone and/or soft tissue injuries of the hand, wrist and/or fingers recruited in four hospitals of the Andalusian Public Health System. Interventions: The experimental group received a home exercise program using a touchscreen tablet application and the control group received a home exercise program on paper. Both groups received the same treatment of face-to-face physiotherapy. Primary outcome: Number of physiotherapy sessions. Secondary outcomes were the duration of physiotherapy and clinical variables such as functional ability, grip strength, pain and manual dexterity. Results: The experimental group required fewer physiotherapy sessions (MD -11,5 sessions; 95% CI -21.4 to -1.4), showed a shorter duration of physiotherapy (MD -3.8 weeks, 95% CI -7 to -1) and had better recovery of grip strength, pain and dexterity compared to the control group. Conclusions: In patients with trauma and soft tissue injuries of the wrist, hand and/or fingers, an exercise program performed on a touchscreen tablet-based app in combination with face-to-face physiotherapy reduces the consumption of face-to-face resources and improves clinical recovery, compared to conventional home exercise program prescribed on paper.

Introducción: El fútbol es el deporte con más jugadores a nivel aficionado como profesional del mundo. En el deporte de alto nivel los requerimientos físicos y psíquicos son excepcionales. Se realizan todo tipo de monitorizaciones de los jugadores para valorar su capacidad de asimilación de las cargas y su estado de recuperación para poder realizar un entrenamiento o un partido. La necesidad de evaluar al jugador correctamente hace que se estudien diferentes marcadores objetivos y subjetivos que nos den un fiel reflejo del estado del jugador para competir al máximo nivel de su capacidad. Objetivos: El objetivo principal de este estudio fue verificar la relación existente entre los parámetros de carga externa de un jugador con los marcadores de carga interna relacionados con el partido de fútbol durante dos temporadas. A su vez como objetivos secundarios, se ha propuesto determinar si la densidad de partidos, es decir, más de un partido por semana, altera los valores de carga interna de un jugador relacionado con un partido. Se intentó especificar si la raza es un factor determinante a la hora de relacionar la carga externa e interna del jugador según la posición de juego. Para finalizar se intentó concretar el número basal de creatinquinasa (CK) que tiene un jugador de fútbol dependiendo de su posición y raza. Metodología: Se llevó a cabo un estudio epidemiológico observacional, descriptivo y transversal con veintinueve jugadores profesionales de fútbol de la liga inglesa del primer equipo del Watford FC. Se les realizaron diferentes medidas antropométricas (edad 27,59 ± 3,83 años, peso corporal 80,16 ± 7,45 kg y altura 183,48 ± 5,83) y se dividió el grupo por posición de juego. Se le realizaron tomas de sangre para evaluar la creatinquinasa antes y después de los partidos. A su vez los jugadores rellenaban un cuestionario de wellbeing subjetivo previo a la toma de sangre. Se cuantificaba la cantidad de metros recorridos y los metros recorridos a diferentes intensid

The assessment of posture and asymmetries is common in musculoskeletal clinical practice, and correction is a frequent goal. In this setting, posture and asymmetries are usually interpreted in terms of musculoskeletal issues. This study aimed to evaluate spinal asymmetries in case studies of unilateral nephroptosis. A systematic review was performed using PubMed, CINAHL, Scopus and Web of Science. We included case reports and case series of nephroptotic patients which showed diagnostic imaging that allowed us to assess the presence of spinal asymmetries in the frontal plane. The methodological quality of the selected studies was assessed by using Case Report (CARE) checklist. Nineteen studies were included, with a total number of 78 reported patients (69 women) ranging 22 to 44 years old (mean: 29). Only one patient presented with medial nephroptosis, while the rest presented with caudal migration. Ninety-one percent of the cases affected to the right kidney. All cases but two showed homolateral flank closure (lower rib descent, iliac crest raise and/or homolateral side-bending). The correction of nephroptosis, either by supine position or surgical treatment, removed asymmetries in some cases while other cases improved only partly. Manual therapists must consider visceral implications while assessing body posture. Further, since the most common symptom of nephroptosis is loin pain, and it has been claimed that loin pain is underdiagnosed, manual therapists should consider its potential presence during clinical practice. Finally, being that nephroptosis shares several features with idiopathic lumbar scoliosis (type of patient, postural adaptation), more research is needed regarding any possible relation between them.

Evidence-Based Practice (EBP) is a cost-effective approach for improving the quality of clinical care and implementing only well-tested evidence. Health professions, especially physiotherapy, must embrace EBP principles. This paper presents normative data from the Spanish physiotherapist population using the Health-Sciences Evidence-Based Practice questionnaire and explores EBP clusters/profiles of professionals in practice. An intentional sample of 419 practicing physiotherapists was recruited from the Spanish Professional Council of Physiotherapy. Participants completed a cross-sectional online survey with 60 Likert items (scale 1–10) measuring 5 dimensions: 1) Beliefs and attitudes, 2) Results from literature, 3) Professional practice, 4) Assessment of results, and 5) Barriers and Facilitators. The protocol also included sociodemographic, training, and practice-related contrast variables. Normative data were estimated and tabulated for each dimension and then a K-means clustering procedure was implemented using the contrast variables. Results for normative data showed, in descending order, the following 50th percentile values for the five EBP factors: Beliefs and attitudes (8.25), Professional practice (8.00), Assessment of results (7.42), Results from literature (6.71), and EBP Barriers and Facilitators (5.17); all expressed on a scale of 1 to 10. Academic degree, EBP training level, and work time shared in healthcare activity, research, or teaching activity were all statistically significant for discriminating EBP dimension scores. Finally, six different clusters showed that when EBP level is low, the scores in all dimensions are equally low, and vice-versa. The EBP dimensions "Beliefs and attitudes", "Professional practice", and "Evaluation of results" obtained better normative scores overall than "Search for bibliographic evidence and its inclusion in practice" and especially "Perception of EBP barriers", which had the worst score. Normative data are useful f

The assessment of posture and asymmetries is common in musculoskeletal clinical practice, and correction is a frequent goal. In this setting, posture and asymmetries are usually interpreted in terms of musculoskeletal issues. This study aimed to evaluate spinal asymmetries in case studies of unilateral nephroptosis. A systematic review was performed using PubMed, CINAHL, Scopus and Web of Science. We included case reports and case series of nephroptotic patients which showed diagnostic imaging that allowed us to assess the presence of spinal asymmetries in the frontal plane. The methodological quality of the selected studies was assessed by using Case Report (CARE) checklist. Nineteen studies were included, with a total number of 78 reported patients (69 women) ranging 22 to 44 years old (mean: 29). Only one patient presented with medial nephroptosis, while the rest presented with caudal migration. Ninety-one percent of the cases affected to the right kidney. All cases but two showed homolateral flank closure (lower rib descent, iliac crest raise and/or homolateral side-bending). The correction of nephroptosis, either by supine position or surgical treatment, removed asymmetries in some cases while other cases improved only partly. Manual therapists must consider visceral implications while assessing body posture. Further, since the most common symptom of nephroptosis is loin pain, and it has been claimed that loin pain is underdiagnosed, manual therapists should consider its potential presence during clinical practice. Finally, being that nephroptosis shares several features with idiopathic lumbar scoliosis (type of patient, postural adaptation), more research is needed regarding any possible relation between them.

The current study was conducted to compare muscle damage biomarkers in single- vs. multi-match weeks in elite soccer players for two consecutive seasons. A secondary objective was to analyze the influence of playing position and exposure time on muscle damage in single- vs. multi-match weeks. This is a prospective cohort study performed in a professional elite soccer club in the English Premier League during the 2018-2019 and 2019-2020 seasons up until the lockdown due to the COVID-19 pandemic. Data were collected in the Medical Department Room of an English Premier League Club before and after the soccer game from a total of 29 elite soccer players (mean +/- S.D.; age = 27.59 +/- 3.83 years; height = 1.83 +/- 0.05 m; body mass = 80.16 +/- 7.45 kg) who were enrolled in the club during both seasons. The main outcome measurements were creatine kinase (CK), weight, lean mass, % fat DEXA, high speed running, total distance, density of total distance and high-speed running and wellbeing questionnaires. Significance was set at p < 0.05. Players who completed more than 60 min in the previous game had significantly increased pregame CK levels and fatigue in multi-match weeks. Midfielders had both significantly increased pregame CK and muscle soreness in multi-match weeks. Midfielders and players with an exposure time of at least 60 min showed higher pregame CK values that should play a key role for deciding substitutions.

Numerous Virtual Reality (VR) systems address post-stroke functional recovery of the lower extremity (LE), most of them with low early applicability due to the gait autonomy they require. The aim of the present study was to evaluate the feasibility of a specific VR treatment and its clinical effect on LE functionality, gait, balance, and trunk control post-stroke. A controlled, prospective, clinical trial was carried out with 20 stroke patients, who were divided into two groups: the first group (VR + CP; n = 10) received combined therapy of 1 h VR and 1 h of conventional physiotherapy (CP) and the second group (CP; n = 10) received 2 h of CP (5 days/week, for 3 weeks). The following pre-post-intervention measuring scales were used: Functional Ambulatory Scale (FAC), Functional Independence Measure (FIM), Fugl-Meyer Assessment (FM), Berg Balance Scale (BBS), and Trunk Control Test (TCT). Only VR + CP showed a significant improvement in FAC. In FIM, CP presented a tendency to significance, whereas VR + CP showed significance. Both groups improved significantly in FM (especially in amplitude/pain in VR + CP and in sensitivity in CP) and in BBS. In TCT, there was a non-significant improvement in both groups. The results indicate that the intervention with VR is a feasible treatment in the post-stroke functional re-education of the LE, with the potential to be an optimal complement of CP.

The current study was conducted to compare muscle damage biomarkers in single- vs. multi-match weeks in elite soccer players for two consecutive seasons. A secondary objective was to analyze the influence of playing position and exposure time on muscle damage in single- vs. multimatch weeks. This is a prospective cohort study performed in a professional elite soccer club in the English Premier League during the 2018–2019 and 2019–2020 seasons up until the lockdown due to the COVID-19 pandemic. Data were collected in the Medical Department Room of an English Premier League Club before and after the soccer game from a total of 29 elite soccer players (mean ± S.D.; age = 27.59 ± 3.83 years; height = 1.83 ± 0.05 m; body mass = 80.16 ± 7.45 kg) who were enrolled in the club during both seasons. The main outcome measurements were creatine kinase (CK), weight, lean mass, % fat DEXA, high speed running, total distance, density of total distance and high-speed running and wellbeing questionnaires. Significance was set at p < 0.05. Players who completed more than 60 min in the previous game had significantly increased pregame CK levels and fatigue in multi-match weeks. Midfielders had both significantly increased pregame CK and muscle soreness in multi-match weeks. Midfielders and players with an exposure time of at least 60 min showed higher pregame CK values that should play a key role for deciding substitutions.

Pain and abnormal somatosensory processing are important associated conditions in children and adolescents with cerebral palsy (CP). Perceived social support is highly relevant for pain perception and coping. Aim: The aim of the present study was to assess the influence of social support on pain sensitivity in children and adolescents with cerebral palsy and healthy peers. Design: Cross-sectional study. Methods: Pressure pain thresholds were assessed in 42 children and adolescents with CP and 190 healthy peers during three different conditions: alone, with their mother and with a stranger. Results: Children with CP reported lower pain sensitivity when they were with their mother than being alone or with a stranger, whereas healthy peers did not experience different pain sensitivity related to the social condition. Sex or clinical characteristics did not affect the relationship between pain perception and social support. Conclusion: The present study shows how children with CP are highly affected by social and contextual influences for regulating pain sensitivity. Solicitous parental support may enhance pain perception in children with CP. Further research on the topic is warranted in order to attain well-founded conclusions for clinical practice

This study aimed to determine the validity of digital vascular auscultation for the assessment of changes in the radial pulse in healthy subjects, using Doppler sonography as a validated test referent. Sixty-one non-symptomatic subjects (mean age of 52.5 ± 16.1 years) were assigned and evaluated under one of the following conditions: In condition 1, blood flow of the radial artery was not modified; for condition 2, blood flow of the radial artery was modified using a pressure sleeve around the humerus. The radial pulse was then measured three times with each diagnostic tool by three different blinded evaluators. Both instruments demonstrated a high association between the identification of blood flow modifications or not and the assigned condition (p < 0.001). A strong concordance between the two devices when detecting the “changes” or “no changes” in blood flow was demonstrated (k = 0.936, p < 0.001). Stethoscope sensitivity was 95%, and specificity was 99%. In conclusion, digital vascular auscultation seems to be a valid technique to examine blood flow changes of the radial artery in non-symptomatic subjects, and it could be useful for physical therapists when combined with provocative tests for the screening of possible thoracic outlet syndrome in patients.

The main goal of this study was to obtain normative data of the scores of the Health-Sciences Evidence Based Practice (HS-EBP) questionnaire, and to analyse evidence-based practice (EBP) among potential clusters of osteopathy professionals in Spain. An online descriptive cross-sectional study has been applied. A total number of 443 Spanish practicing osteopaths answered a survey including the 5 dimensions of the HS-EBP questionnaire and sociodemographic, training, and practice variables using the “LimeSurvey” online platform. Results point out that the median scores for each five HS-EBP questionnaire dimensions were 95.00, 86.00, 78.00, 84.00 and 62.00 considering that the range of possible scores in each of the dimensions was: from 12 to 120 in dimensions 1, 4 and 5; from 14–140 in dimension 2; and from 10–100 in dimension 3. A clustering algorithm extracted 6 different profiles across the five HS-EBP latent dimensions: low scores in all dimensions (cluster 1); low scores in all dimensions but with medium scores in dimension 1 (cluster 2); mixed pattern of scores, low in dimensions 2 and 5 and medium in the rest of the dimensions; medium scores in all dimensions (cluster 4); high scores in all dimensions and low scores in dimension 5 (cluster 5); and high scores in all dimensions (cluster 6). Significant relationship was found among the response patterns in the clusters and: academic degree level, EBP training and training level, and work time invested in healthcare activity, research and teaching activity. These results allow a description of the actual level of EBP and differential profiles of Osteopathy care practice in Spain. Knowledge of normative scores of the HS-EBP questionnaire and identification of different predictors of Spanish osteopaths’ EBP, e.g., academic degree, EBP training and training level, work time invested in healthcare activity, research, and teaching activity, and having a working relationship with an accredited educational centre, enable

This study aimed to determine the validity of digital vascular auscultation for the assessment of changes in the radial pulse in healthy subjects, using Doppler sonography as a validated test referent. Sixty-one non-symptomatic subjects (mean age of 52.5 ± 16.1 years) were assigned and evaluated under one of the following conditions: In condition 1, blood flow of the radial artery was not modified; for condition 2, blood flow of the radial artery was modified using a pressure sleeve around the humerus. The radial pulse was then measured three times with each diagnostic tool by three different blinded evaluators. Both instruments demonstrated a high association between the identification of blood flow modifications or not and the assigned condition (p < 0.001). A strong concordance between the two devices when detecting the “changes” or “no changes” in blood flow was demonstrated (k = 0.936, p < 0.001). Stethoscope sensitivity was 95%, and specificity was 99%. In conclusion, digital vascular auscultation seems to be a valid technique to examine blood flow changes of the radial artery in non-symptomatic subjects, and it could be useful for physical therapists when combined with provocative tests for the screening of possible thoracic outlet syndrome in patients.