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PURPOSE To determine the clinical relevance of the effects that Massage-Therapy (MT) and Abdominal-Hypopressive-Gymnastics (AHG) and the combination of both procedures have on the disability, pain intensity, quality of life, and lumbar mobility of patients with chronic nonspecific low back pain (CNSLBP). METHODS A randomized controlled-trial with parallel-groups, concealed allocation, assessor blinding, and intention-to-treat analysis was carried out. The sample included 60 adults with CNSLBP. The participants received MT (n = 20), AHG (n = 20), or MT + AHG (n = 20). Each group received 8 interventions. RESULTS The ODI change scores were significantly higher (p

Resumen Antecedentes/objetivo El diagnostico de fisioterapia es uno de los eslabones menos desarrollados en la profesion y, aunque se reconoce a la Clasificacion Internacional del Funcionamiento (CIF) como marco teorico, no se interpretan adecuadamente las propuestas y etiquetas diagnosticas. El objetivo de este estudio es describir los elementos clave que configuran el diagnostico en fisioterapia integrando el contexto de la CIF. Metodo Estudio descriptivo, observacional, transversal de corte cualitativo, basado en el modelo de analisis interpretativo de Grounded Theory. En primer lugar, se lleva a cabo una encuesta tipo Likert (n = 42) y, en segundo lugar, se realiza un analisis interpretativo de un grupo de discusion. Resultados El diagnostico de fisioterapia es percibido por los participantes del grupo de discusion como un sello de identidad de la profesion, por su objetividad, su caracter cientifico y por favorecer la comunicacion interdisciplinar. Se identificaron trece codigos organizados en cuatro categorias. Estas categorias son: las areas de desarrollo del diagnostico de fisioterapia, los perfiles de los fisioterapeutas, los conocimientos sobre la Clasificacion, y las competencias de la Clasificacion. Los codigos que definen estas categorias son, respectivamente: los roles academico, profesional e investigador; los perfiles clinico-asistencial, cientifico y afectivo-emocional; las definiciones, desventajas, mejoras y utilidad en el diagnostico de fisioterapia; y los componentes de salud, conjuntos basicos y nivel internacional. Conclusion Los codigos obtenidos definen el diagnostico de fisioterapia en el contexto actual de la CIF. Estos son aspectos para el estudio y elementos de referencia para desarrollar etiquetas diagnosticas acordes con las necesidades de la fisioterapia actual.

Objectives. Proprioceptive training is popularly applied as a therapeutic exercise method in physiotherapy. Its effects on pain and range of motion are only poorly evaluated. Therefore, this study assesses the effectiveness of proprioceptive training with an Eye-Cervical Re-education Program to decrease pain and increase the joint range in chronic neck pain patients. Material and Methods. Design. A randomized, no-blinded, controlled clinical trial. Setting. Physiotherapy consultation. Participants. 44 people were divided into two groups. Interventions. All patients were treated with a multimodal physiotherapy intervention. The experimental group was supplemented with an exercise program that included eye-cervical proprioception. Outcomes. The primary outcomes included pain pressure thresholds (upper trapezius, levator scapulae, and splenius capitis) and cervical range of motion. The secondary outcomes included pain measured by the Visual Analogical Scale and the McGillSpv Questionnaire. Results. The proprioception treatment was effective in reducing the pain pressure threshold in the right upper trapezius (p=0.001), left upper trapezius (p=0.014), right levator scapula (p=0.040), and left splenius capitis (p=0.021). The increase in the joint range was statistically significant (p<0.05) in favor of the Eye-Cervical Re-education Program for all movements assessed. Conclusions. The Eye-Cervical Re-education Program is effective at relieving pain pressure thresholds in the upper trapezius, right levator scapula, and left splenius capitis and especially effective for increasing the cervical range of motion. This trial is registered with NCT03197285 (retrospective registration).

Objective. To determine the short-term effects of infant massage on the development of Down syndrome babies. Materials and Methods. The study compared two groups (intervention and control), each with 16 babies with Down syndrome between 4 and 8 months old. The variables developmental age and developmental quotient were measured at two distinct time points, at pretest and after 5 weeks, using the Brunet-Lézine Early Childhood Psychomotor Development revised scale. This scale measures the variables of age and development quotient in a partial way (motor, visual-motor coordination, language, and social development) and in a global way. The experimental group received infant massage, applied by the parents, during these 5 weeks, every day for at least 10 minutes. The massage protocol was based on the methodology created by Vimala McClure. The control group received it after 5 weeks. Results. All developmental variables were improved in the experimental group but not in the control group. There were significant differences in developmental age between the two groups, and this outcome was better in the experimental group (p<0.001). The 2-by-2 mixed-model analysis of variance indicates a statistically significant group-by-time interaction for all development quotients, both partial and global (p<0.001), which was significantly higher in the experimental group than in the control group. Conclusion. Infant massage therapy improves the development of babies with Down syndrome in the short term.

Resumen Objetivo Conocer el nivel de calidad de vida profesional percibida por los fisioterapeutas del ambito hospitalario publico del area metropolitana de Sevilla y analizar su relacion con variables sociodemograficas y laborales. Material y metodos Estudio multicentrico descriptivo transversal, desarrollado en el area metropolitana de Sevilla: Hospital Universitario Virgen del Rocio, Virgen Macarena y Virgen de Valme. Los participantes fueron todos los fisioterapeutas de los hospitales anteriormente citados. La tasa de respuesta fue del 96% (n = 48). Instrumentos de medida: encuesta anonima que incluye el cuestionario de calidad de vida profesional CVP-35, ademas de variables sociodemograficas y laborales. Resultados El perfil del fisioterapeuta es una mujer (72,9%), de 44 anos (Q1 41,75; Q3 57), casada (79,2%), con 2 hijos (Q1 1; Q3 2), con un tiempo de experiencia profesional de 22 anos (Q1 16,25; Q3 30), con una antiguedad en el puesto de 6,5 anos (Q1 4; Q3 16,83), plaza en propiedad (64,6%), jornada completa (89,6%) y turno de manana (95,8%). La valoracion global sobre la calidad de vida profesional percibida es de 7 puntos (Q1 5; Q3 8). En relacion con las 3 dimensiones valoradas, la media mas alta se encuentra en la «motivacion intrinseca», con 8,17 (DT 1), «cargas de trabajo», con 6,06 (DT 1,2), y «apoyo directivo», con 5,38 (DT 1,54). No existen diferencias estadisticamente significativas con las variables sociolaborales. Conclusiones Los fisioterapeutas de los hospitales de la ciudad de Sevilla tienen una calidad de vida en el trabajo media-alta. Presentan una adecuada motivacion para realizar su trabajo, pero muestran cierta insatisfaccion relacionada con el apoyo directivo y la carga de trabajo.

Zika virus (Zikv) infection implies a significant public health issue due to the different syndromes associated. It is related to several central nervous system problems, such as microcephaly and Guillain-Barre Syndrome. In this way, the first document about the relation of Guillain-Barre Syndrome and Zika indexed in Web of Science was published in 2014. Therefore, the primary goal of the present study is to analyze the leading scientific producers, the relative specialization of the countries and the collaboration network in the research area. A total of 384 manuscripts were identified. Two manuscripts were published in 2014 and 2015; the remaining documents are distributed during 2016 (136), 2017 (186) and 2018 (59) (until April). In conclusion, Zikv and Guillain-Barre Syndrome research has experienced a significant increase in the last years. This may be related to the topic is an important issue of public health concern in the countries affected by Zikv outbreaks. In that sense, Brazil, India and Colombia make a great effort, considering their economic and social resources, in research. However, this study implies a preliminary overview of the research on this topic, a more extended period is needed to define the lines of research and collaboration between countries and authors.

To determine the effectiveness of Craniosacral Therapy (CST) for the treatment of infantile colic.This randomized controlled trial was conducted on 58 infants, aged 0-84 days, diagnosed with infantile colic. The babies received a 30-40 minute CST session once a week (experimental group) or no treatment (control group). Babies in the CST group received either 1, 2 or 3 CST sessions over a 14-day period. Data were collected at 4 different times over the 24-day period, day 0 (baseline), day 7, day 14 and day 24. Crying (primary outcome) and sleep (secondary outcome) were evaluated using a crying and sleep diary, and colic severity was measured using the Infant Colic Severity Questionnaire (secondary outcome).There was a statistically significant difference between groups (CST and control) in crying hours (F = 188.47; p 0.0005; η2 = 0.78), sleep hours (F = 61.20; p 0.0005, η2 = 0.54) and colic severity (F = 143.74; p 0.0005, η2 = 0.73) across all the time points. In comparison with the control group, CST babies reported significant and clinically relevant effects in crying hours on day 7 (-2.47 h (95%CI, -2.95 to -1.99); p 0.0005; d = 1.73), on day 14 (-3.29 h (95%CI, -3.7 to -2.8); p 0.0005; d = 2.87) and on day 24 (-3.20 h (95%CI, -3.7 to -2.6); p 0.0005; d = 2.54); in sleep hours on day 7 (-2.47 h (95%CI, -2.95 to -1.99); p 0.0005; d = 1.73) on day 14 (-3.29 h (95%CI, -3.7 to -2.8); p 0.0005; d = 2.87) and on day 24 (-3.20 h (95%CI, -3.7 to -2.6); p 0.0005; d = 2.54).Craniosacral therapy appears to be effective and safe for infantile colic by reducing the number of crying hours, the colic severity and increasing the total hours of sleep.

Background. There are a great number of interventions in physiotherapy, but with little evidence of their effectiveness in chronic low back pain. Therefore, this study assesses effectiveness of Massage Therapy and Abdominal Hypopressive Gymnastics and the combination of both to decrease pain and lumbar disability while increasing joint mobility and quality of life in patients with chronic nonspecific low back pain. Methods. A randomized, single-blinded, controlled, clinical trial with sample (n=27) was comprised of patients between 20 and 65 years, diagnosed with pain of mechanical origin characterized by having a duration of at least 12 weeks and no serious complications. Each group received 8 interventions of 30 minutes. Results. Friedman ANOVA test obtained statistically significant differences of Oswestry, NRS, and Schober variables (p<0.05) in the three measurements (pretest, posttest 1, and posttest 2), in each individual group. ANOVA Kruskal-Wallis test was used for comparison between groups, and Oswestry Disability values were significantly higher (p=0.024) in the group receiving both treatments. Conclusion. Both individual groups reduce pain levels, improve disability, and increase the flexibility of the lumbar spine. The combination therapy provides greater benefits in terms of lumbar disability. This study is registered on March 8, 2016, with NCT02721914.

To determine if ultrasound (US) is effective in reducing pain and mobility limitation in the treatment of traumatic cervical sprain, we performed an experimental study. The sample comprised 54 diagnosed subjects with a mean age of 36.54 y (standard deviation = 12.245), assigned by simple random selection to an experimental group with ultrasound treatment and a control group with placebo ultrasound. Treatment consisted of 10 sessions of an ultrasound treatment protocol, followed by 15 sessions of a protocol identical for both groups without ultrasound. The variables assessed were pain and joint mobility. There was no significant difference (p > 0.05) between groups in the first 10 sessions of treatment. However, there was a statistically significant difference (p < 0.05) between groups on the pain variable, 20 days after completion of the US. High-active ultrasound treatment is more effective than placebo in reducing pain.

The fragile X syndrome is a mutation-driven developmental disorder caused by a repetition over 200 times of the CGG trinucleotide situated in the 5′-untranslated region of the fragile X mental retardation 1 gene (FMR1). The interval between 55 and 199 CGG repeats, which is over the normal range but below full mutation, is named fragile X premutation. Recent studies have focused on the asymptomatic state of fragile X premutation carriers and their potentially relevant preclinical features. However, the underlying neurological mechanisms leading to altered functions in fragile X premutation carriers are still poorly understood. In this study, we wanted to test the hypothesis that asymptomatic women who carry the fragile X premutation present GABAergic and cerebellar abnormalities compared with healthy women without the premutation. We performed noninvasive brain stimulation protocols on both asymptomatic fragile X premutation carriers and controls comprising of measures of GABAA- and GABAB-mediated intracortical inhibition, afferent inhibition, and cerebello-motor functional interactions. Premutation carriers presented an absence of cerebellar inhibition over primary motor cortex as well as a reduced GABAA-mediated intracortical and afferent inhibition compared with healthy nonpremutated controls. These alterations are most probably dependent on a dysfunctional GABAergic mechanism associated with the fragile X premutation condition as previously found in CGG-repeat animal models. Furthermore, the lack of cerebello-motor inhibition could be related to the cerebellar structural abnormalities previously found in carriers of the premutation. © 2013 the American Physiological Society., This work was supported by grants from the Ministerio de Economía y Competitividad de España (SAF2007-60700); Instituto de Salud Carlos III (PI10/01674, CP08/00174); Consejería de Economía, Innovación, Ciencia y Empleo de la Junta de Andalucía (CVI-02526, CTS-7685); Consejería de Salud y Bienestar Social de la Junta de Andalucía (PI-0377/2007, PI-0741/2010, PI-0437-2012); Sociedad Andaluza de Neurología; Jacques and Gloria Gossweiler Foundation; and Fundación Alicia Koplowitz.

DNA methylation is recognized increasingly for its prominent role in controlling diverse immune processes. In this study, we show that in Jurkat T cells and fresh peripheral lymphocytes, short-time incubation with protein kinase C activators or phosphatase inhibitors down-regulate DNA methylation activity in a dose-dependent manner. This inhibition correlates with the induction of the interferon-γ (IFN-γ) gene, which contains several CG sequences in its promoter. The expression of mRNA and protein of the different DNA methyltransferases did not decrease after the treatment. In addition, sulfydryl reagents have a strong inhibitory effect on DNA methylation activity and also induce IFN-γ gene expression, thus suggesting a link between both effects.

The variable phenotype in female carriers of a full mutation is explained in part by non-random X-chromosome inactivation. The molecular diagnosis of fragile X syndrome is based on the resolution of the number of CGG triplet repeats and the methylation status of a critical CpG in the fragile X mental retardation gene (FMR1) promoter. Neighboring CpGs in the FMR1 promoter are supposed to be equally methylated or unmethylated.Southern blot analysis was performed with double digestion, either with EcoRI/EagI or with HindIII/SacII. The EagI restriction site was studied by sequencing. The fragile X encoded protein (FMRP) was detected in white blood cells by Western blot. The fragile X phenotype was evaluated by specific clinical examinations.Within one family we found three female carriers of a full mutation and a different degree of methylation of the normal allele that correlated with the levels of FMRP in blood and the fragile X phenotype. Complete methylation at the EagI CpG target (but partially methylated SacII CpG site) was associated with extremely skewed X inactivation (confirmed by analysis of the methylation status at the PGK locus), undetectable FMRP in blood, and a male-like phenotype.In fully mutated female carriers the methylation status at the EagI restriction site correlates with the levels of FMRP in blood and the fragile X phenotype. Neighboring CpG sequences in the FMR1 promoter can be differentially methylated, which should be taken into consideration for molecular diagnosis.

El equilibrio es un aspecto fundamental para las actividades de la vida diaria y para el deporte. El deterioro en esta capacidad puede ocasionar trastornos o lesiones por caídas. El objetivo de esta intervención es determinar la influencia de un programa de ejercicios propioceptivos con feedback externo auditivo sobre la mejora del equilibrio. Participaron ocho mujeres (M = 38 años, DE = 11.45) que realizaban ejercicio constante, dividas en dos grupos. Grupo 1 programa y feedback auditivo, grupo 2 solo programa. Se creó un equipo de feedback auditivo que fue utilizado para el grupo 1. En los resultados el Grupo 1 tuvo la mejoría significativa en equilibrio medido con los siguientes test: Functional Reach (p = .036), Get Up and Go (p = .021) y Test Dinámico en Barra (p = .044). De acuerdo a los resultados obtenidos, los dos grupos presentan una mejoría en el equilibrio por el programa propioceptivo, pero es el grupo 1 con feedback auditivo, el que tuvo la mayor mejoría. El programa propioceptivo unido a feedback auditivo puede mejorar significativamente el equilibrio. Balance is an essential aspect of daily living and sport appearance. The deterioration of this capacity may cause disorder or injury from falls. The objective of this intervention is to determine the influence of proprioceptive exercise program with external auditory feedback on balance improvement. It involved eight women ( M = 38 years, SD = 11.45) who performed constant exercise, divided into two groups. Group 1 program and auditory feedback, group 2 single program. A team of auditory feedback that was used for group 1 was created. Results in Group 1 had a significant improvement in measured equilibrium with the following tests: Functional Reach ( p = .036), Get Up and Go ( p = .021) and Dynamic Bar test ( p = .044). According to the results, the two groups displayed an improvement in the balance by the proprioceptive program, but it was group 1, with auditory feedback, which shown the greatest improvement. The proprioceptive program along with auditory feedback can improve balance significantl O equilíbrio é um aspecto fundamental para as actividades da vida diária e para o esporte. A deterioração desta capacidade pode originar perturbações ou lesões devido a quedas. O objectivo desta intervenção é determinar a influência de um programa de exercícios propioceptivos com feedback auditivo externo sobre a melhoria do equilíbrio. Participaram no estudo oito mulheres ( M = 38 anos, DP = 11.45) que realizavam exercício constante, divididas em dois grupos. Grupo 1 programa e feedback auditivo, Grupo 2 apenas programa. Foi criada uma equipa de feedback auditivo que foi utilizada para o Grupo 1. Os resultados indicam que o Grupo 1 apresentou uma melhoria significativa do equilíbrio medido através dos seguintes testes: Functional Reach ( p = .036), Get Up and Go ( p = .021) e Teste Dinâmico em Barra ( p = .044). De acordo com os resultados obtidos, ambos os grupos apresentam uma melhoria no equilíbrio através do programa propioceptivo, contudo, o Grupo 1 com feedback auditivo, foi o que teve uma melhoria superior. O programa propioceptivo, juntamente com o feedback auditivo, pode melhorar significativamente o equilíbrio

Background Self-efficacy appears to be an important predictor of functional recovery for women with urinary incontinence, but no specific Spanish-language questionnaires for measuring pelvic-floor exercise self-efficacy exist. Objective The aim of this study was to design a valid and reliable Spanish version of the Broome Pelvic Muscle Self-Efficacy Scale to measure self-efficacy, as perceived by women with urinary incontinence, in performing pelvic-floor exercises. Design This was an observational validation study. Methods Translation-back translation was used to design the survey, and then the survey was validated with a sample of 119 women who were incontinent and had undergone a pelvic-floor exercise training program. The reliability and construct validity of the questionnaire were assessed. Descriptive statistics were used to score the questionnaire. Internal consistency was evaluated with the Cronbach alpha coefficient and the Pearson correlation coefficient. Exploratory factor analysis with both the principal components extraction method and the varimax rotation method was used to assess construct validity. Results The reliability coefficient (Cronbach alpha=.91) and the correlations among items were high. The factor analysis revealed that 6 main factors accounted for 75.8% of the variance. Limitations Conclusions regarding the validity of the questionnaire should be drawn with caution because of the inability to assess criterion-related validity. Conclusions The Spanish version of the Broome questionnaire for self-efficacy appears to be useful as a measuring tool for a psychometrically accurate, clinically relevant estimation of women's self-efficacy in performing pelvic-floor exercises.

17 páginas, 3 figuras, 2 tablas.-- et al., Modifications in the GABA pathway are considered to be responsible for motor alterations in animal models for fragile X-associated tremor ataxia syndrome. We analyzed the expression profile in the cerebellum in a transgenic mouse model that over expresses the human FMR1 gene with CGG repeats in the normal range. We used the “GeneChip Mouse Gene 1.0 ST Array” from Affymetrix analyzing 28,853 well-described and -characterized genes. Based on data from the comparative analysis of the expression profile, we detected a significant gradient with a P value, Research supported by a Grant from the Instituto de Salud Carlos III, Ministerio de Educación y Ciencia de España (#PI081332). J.J. Fernández was supported by a fellowship from the Hospital Universitario Virgen Macarena de Sevilla.

Normally, when the patient's functional recovery involves partial weight-bearing aided walking using forearm crutches, it is not possible to control the amount of weight-bearing objectively that the individuals carry out and its progression. This leads to significant errors in accuracy and, consequently, complications and after effects in pathologies. To compensate for this deficiency, we have set out to design and validate a measurement system and a computerized record of the loads exerted on Canadian crutches in aided walking as well as incorporating a mechanism for acoustic and visual biofeedback that will inform the subject if said charges are correct, so that they are able correct their errors and avoid problems in their recovery. We analyzed the validity and reliability of the system through a concordance study with the AMTI OR6-7-2000 force plate, extensively validated previously, while finding a correlation coefficient of 0.99 with a significance (p0.001). We have designed and developed a measurement system with a computerized record, analysis and wireless graphical display of real-time data, incorporating a mechanism for acoustic and visual biofeedback to measure the loads exerted on forearm crutches during aided walking. The device, called "GCH System 1.0" is a reliable and valid instrument.

Los estudios de carácter histórico sobre la Fisioterapia en España son escasos, y los que hay se caracterizan por la dispersión de los datos y por el déficit en la citación de las fuentes. Motivados por factores personales y profesionales, ante la adaptación de los nuevos modelos educativos y sanitarios y tras 50 años de historia, planteamos nuestro problema de investigación centrado en la siguiente pregunta: ¿cuáles han sido los elementos sustanciales o fuerzas de cambio que pueden considerarse puntos de inflexión en el recorrido de la Fisioterapia Española en la segunda mitad del siglo XX? La Fisioterapia en España, aunque presenta profundas raíces históricas en siglos precedentes, también manifiesta un cierto retraso en cuanto a su consolidación como profesión independiente y como Ciencia autónoma; pensemos que en este sentido es la década de los 80 una de las más importantes para el desarrollo de la Fisioterapia contemporánea española, lo cual se refleja al estudiar como otras ciencias han avanzado para ser consideradas como tales. Así, a través de autores universales para la Ciencia como Popper, Kuhn, Lakatos y Merton, afrontamos en este trabajo desde un marco teórico sobre la fundamentación del proceso científico al que de forma emergente se está asomando de forma emergente la Fisioterapia. Estos autores nos permiten acercarnos a la filosofía, la historia y la sociología de la Ciencia, tres pilares fundamentales de un nuevo modelo de concebir el progreso del conocimiento a través de la historia que se denomina "Enfoque Ciencia, Tecnología y Sociedad (CTS)". Este modelo enmarca el crecimiento de la Ciencia en interacción con los aspectos sociales el impacto de las tecnologías en su desarrollo; así, entendemos que la evolución de la Fisioterapia (desde su vertiente científica considerando que en su avance todo lo social juega un papel determinante, además de las distintas tecnologías que se han ido incorporando en los últimos años) puede ser estudiada desde este enfoque globalizador que está siendo aceptado por todas las corrientes de pensamiento actuales. Este trabajo lo elaboramos sobre dos objetivos generales: identificar y describir los rasgos explicativos del desarrollo de la Fisioterapia española de la 2a mitad del siglo XX desde el enfoque CTS y conocer la estructura multidimensional que caracteriza al desarrollo de la Fisioterapia en España en este momento histórico. El presente estudio responde a una investigación de corte histórico cuyo propósito es reconstruir la historia de la Fisioterapia en el siglo XX a partir de fuentes documentales (aproximadamente 1200) y fuertes vivas (36 sujetos entrevistados). Por tanto, el diseño de este trabajo corresponde a un estudio descriptivo exploratorio que sigue un método histórico comparativo cronológico (habiendo identificado 149 modalidades categóricas que conforman 5 variables). Para el análisis de datos se han utilizado los programas SPSS 15, SPAD n y Atlas 5 realizándose descriptivos estándar, análisis de correspondencias múltiples y análisis tipo clúster. Las líneas generales de los resultados obtenidos son que los rasgos explicativos del desarrollo de la Fisioterapia española se vertebran en torno a la triangulación de hechos académicos, profesionales y científicos, presentando los académicos una evolución irregular y siguiendo una línea de continuidad los profesionales y científicos.

Background: Relevance: Post-traumatic cervical sprain, caused by whiplash is the most common injury in traffic accidents. This pathology is complicated by the disorders associated with it. Studies performed on cadavers enumerate endless lists of anatomical lesions that may occur as a result of whiplash, such as involvement of the facet joints, intervertebral discs, muscles, ligaments, of the atlas-axis region of the cervical vertebrae, etc. The pain caused by tissue damage stimulates stress which prevents muscle relaxation and joint mobility. US is one of the electrophysical methods most used by physiotherapists to treat pain. Some authors deny its effectiveness for this purpose, and others who think that not getting “benefits” is that the doses used are not appropriate. Purpose: To examine the effectiveness of the therapeutic ultrasound (US) in the treatment of pain in posttraumatic acute cervical sprain. Methods: Participants: 54 patients diagnosed with cervical sprain grade I and II (20 men and 34 women) with mean age of 36.54 years (SD= 12,245), gave informed written consent. Methods: An analytical, longitudinal, prospective, experimental study with blinded patient and assessor, with two parallel groups was performed. Sample: Randomization and Intervention: subjects by simple random to an experimental group (27 subjects) of ultrasonic treatment and a control group (27 subjects) were assigned placebo ultrasound. Therapy (25 sessions) consists of: (1) 10 sessions of more ultrasound treatment protocol and (2) 15 identical protocol sessions for both groups without ultrasonics. Dependent variables measured with the Visual Analog Scale (VAS) pain scale and algometer before starting the first session (pretest), eleventh (postest 10) and at end of the twenty-fifth session (postest 25). Results: Analysis: Data were analyzed used Student’s t test for independent samples tWelch and Mann–Whitney U as appropriate. Results: No significant difference (p> 0.05) between groups in the first ten days of treatment (most US). Yes there is a statistically significant difference (p< 0.05) between groups for pain variable, 15 days after completion of the implementation of the US (the active ultrasound is more effective than placebo), with a moderate effect size (between .51 and .64), mean (SD) for the control group and experimental variables respectively for improvements to high scale measures EVA 5.24 (1.25) 6.16 (1.89), with right trapezius algometer at 1.6 (1.30) 2.3 (1.20) and left 1.99 (1.32) 2.62 (1.39) in the right scapula angle 2.15 (1.08) 2.83 (1.60) and left 2.27 (1.54) 3.16 (1.32). Conclusion(s): 15 days after the end of the implementation of the US, the active ultrasound is more effective than placebo in reducing pain. Implications: The US does not have an antiinflammatory, but pro-inflammatory effect, since it stimulates edema formation and its subsequent disappearance more quickly. US application at certain doses, powers a cascade of phenomena which are produced normally, which results in a higher effective resolution of the pain.

Background: Measurement of first and second metatarsal and toe protrusion is frequently used to explain foot problems using x-rays, osteological measurements or palpation-based tests. Length differences could be related to the appearance of problems in the foot. A test-retest design was conducted in order to establish the intra-rater reliability of three palpation-based tests. Methods: 202 feet of physical therapy students and teachers of the CEU San Pablo University of Madrid, 39 men and 62 women, were measured using three different tests. Data were analysed using SPSS version 15.0. Mean, SD and 95% CI were calculated for each variable. A normal distribution of quantitative data was assessed using the Kolmogorov-Smirnov test. The test-retest intra-rater reliability was assessed using an Intraclass Correlation Coefficient (ICC). The Standard Error Mean (SEM) and the Minimal Detectable Change (MDC) were also obtained. Results: All the ICC values showed a high degree of reliability (Test 1 = 0.97, Test 2 = 0.86 and Test 3 = 0.88) as did the SEM (Test 1 = 0.07, Test 2 = 0.10 and Test 3 = 0.11) and the MDC (Test 1 = 0.21, Test 2 = 0.30 and Test 3 = 0.31). Conclusions: Reliability of measuring first and second metatarsal and toe protrusion using the three palpation-based tests showed a high degree of reliability.

Pregnancy loss is an important reproductive problem which appears to be highly associated with genetic factors. A spontaneous abortion occurred before prenatal diagnosis could be performed, in a woman who carried a fragile X full mutation. DNA extracted from formalin-fixed para ffin-embedded chorionic villi preparations indicated that it was a male embryo with an apparently methylated X chromosome. The previous analysis of the family showed that her daughter, who also carried a full mutation, exhibited an extremely skewed X inactivation of the normal allele (100%) and a severe fragile X phenotype. Thus, we speculate that the aberrant pattern of X chromosome methylation in this family may provoke the spontaneous miscarriage of this pregnancy that could be explained by at least partial inactivation of the unique X chromosome in a male foetus. Spontaneous abortion occurs quite frequently in humans, and recurrent pregnancy loss is a significant problem in women’s health (Christiansen 2006). Many cases of spontaneous abortion defy diagnosis and genetic factors have been proposed as a major contribution (Lanasa and Hogge 2000; Sierra and Stephenson 2006). The X chromosome inactiva tion (XCI) is the process in which one of the two X chromosomes present in each cell of female mammals is inactivated during early embryogenesis, to achieve dosage compensation with males (Avner and Heard 2001; Heard 2004). Initial steps of XCI involve a ‘counting process’, which senses the X chromosome/autosome ratio that restricts XCI to female embryos and, thereafter, the choice of which chromosome is inactivated (Morey et al . 2004).Skewed XCI leads to an expression of X-linked recessive disorders in females (Plenge et al. 2002; Mart´ınez et al. 2005; Renault et al. 2007). Another form of X-inactivation called meiotic sex chromosome inactivation (MSCI), takes place in males, during spermatogenesis and is a manifestation of the general meiotic-silencing mechanism (Turner 2007). In this study, we report the spontaneous abortion of a male foetus with an apparently methylated X chromosome, and propose that anomalous inactivation of its uniqueX chromosome could explain nonviability of the embryo and pregnancy loss. Therefore, we strongly suggest, as a follow up, that the methylation status of the X chromosome be tested in early spontaneous abortion of males in the absence of any other known genetic or nongenetic cause.