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Education in the XXI century is called to move forward in the right direction and to gain momentum to face diverse challenges and take opportunities offered by the knowledge that is inherent in society. Therefore, it can be postulated that there must be a close relationship between learning, the generation of knowledge, continuous innovation and the use of new technologies. This is a cross-sectional descriptive study conducted among a sample of 242 first year and second year Cadiz University nursing students, using the validated Learning and Study Strategies Inventory questionnaire to assess motivation and the Relationship between Learning Styles and Information and Communication Technologies questionnaire to assess knowledge, use and attitude. The predominant profile type of nursing degree students was women under 21 years old, who were single and exclusively dedicated to their studies. In addition, they showed positive motivation in relation to learning while facing adversity (between 76% and 76.6%). Regarding the level of knowledge, use and attitude towards ICTs, most of the considered items presented high values. For some questions, age was proven to be a sociodemographic variable that influenced both the motivation and attitude of the students. The level of knowledge, use and attitude that students have regarding ICTs are good when we refer to communication technologies, interpersonal relationships or basic programs. However, they are low when considering programs related to education or learning.

Knee osteoarthritis (OA) is the most common joint disease. The administration of nonsteroidal anti-inflammatory drugs (NSAIDs) by phonophoresis is a therapeutic alternative to relieve pain in inflammatory pathologies. The main aim was to analyze the efficacy of the application of NSAIDs by phonophoresis in knee OA. A systematic review and meta-analysis of controlled clinical trials were performed between January and March 2021 in the following databases: Web of Science, Scopus, PubMed, Cinahl, SciELO, and PEDro. The PEDro scale was used to evaluate the level of evidence of the selected studies. The RevMan 5.4 statistical software was used to obtain the meta-analysis. Eight studies were included, of which five were included in the meta-analysis, involving 195 participants. The NSAIDs used through phonophoresis were ibuprofen, piroxicam, diclofenac sodium, diclofenac diethylammonium, ketoprofen, and methyl salicylate. The overall result for pain showed not-conclusive results, but a trend toward significance was found in favor of the phonophoresis group compared to the control group (standardized mean difference (SMD) = -0.92; 95% confidence interval: -1.87-0.02). Favorable results were obtained for physical function (SMD = -1.34; 95% CI: -2.00-0.68). Based on the selected studies, the application of NSAIDs by phonophoresis is effective in relieving the symptoms of knee OA. Future long-term studies are recommended., Erasmus + Strategic Partnership for Higher Education Program: 2020-1-PL01-KA203-081905.

Carpal tunnel syndrome is a neuropathic disease. It is one of the most frequent musculoskeletal pathologies affecting the upper limbs. One of most frequently used non-surgical treatments is corticosteorids. There are several alternatives for corticosteroids administration. One of them is phonophoresis, this being an effective and painless method of treatment. A systematic review and meta-analysis have been conducted over the use of phonophoresis with corticosteroids for the treatment of carpal tunnel syndrome compared to other non-surgical treatment methods. Keywords from Medical Subjects Headings (MeSH) were used in the following databases: Wos, Scopus, CINHAL, SciELO and PeDro. A total of 222 potentially relevant articles were retrieved. Eleven articles analysing the efficacy of phonophoresis with corticosteroids in reducing pain symptoms in individuals with carpal tunnel syndrome were included, 10 of which were used to conduct the meta-analysis. A conclusion could not be reached as to the application of phonophoresis with corticosteroids being better than other treatment methods, except for the perception of pain and an improved motor and sensory nerve conduction in cases of mild to moderate carpal tunnel syndrome.

Breast cancer treatments can trigger respiratory sequelae. Respiratory physiotherapy helps to eliminate or mitigate the sequelae by optimizing respiratory function. This systematic review aims to synthesize the scientific evidence and assess its quality regarding the use of respiratory physiotherapy in the sequelae of breast cancer. The Cochrane Library, Physiotherapy Evidence Database, PubMed, Web of Science, Scientific Electronic Library Online, Cumulative Index of Nursing and Allied Literature Complete, and Scopus were searched. Study quality was determined using the PEDro scale, STROBE Statement, and Single-Case Experimental Design Scale. Ten studies, six clinical trials, one case study, and three observational studies were selected. The mean methodological quality of the clinical trials was 5.6, that of the case study was 7, and that of the observational studies was 56%. Respiratory physiotherapy has been observed to improve respiratory capacity, lung function, respiratory muscle strength, effort tolerance, dyspnea, fatigue, thoracic mobility, upper limb volume, sleep quality and quality of life, as well as sensitivity to adverse physiological reactions, nausea, vomiting, and anxiety. However, it is not effective for vasomotor symptoms. More clinical trials are needed. These studies should homogenize the techniques used, as well as improve their methodological quality This research was funded by the Department of Nursing and Physiotherapy (University of Cadiz). Partial funding for open access charge: Universidad de Málaga

Background: The aim of this systematic review and meta-analysis was to evaluate the global postural re-education (GPR) program's effectiveness compared to other exercise programs in subjects with persistent chronic low back pain. Methods: A systematic review and meta-analysis were carried out using PRISMA2020. An electronic search of scientific databases was performed from their inception to January 2021. Randomized controlled trials that analyzed pain and patient-reported outcomes were included in this review. Four meta-analyses were performed. The outcomes analyzed were disability due to back pain and pain. The risk of bias and quality of evidence were evaluated. The final search was conducted in March. Results: Seven trials were included, totaling 334 patients. The results showed improvement in pain measured by Visual Analogue Scale (VAS) (Standardised Mean Difference (SMD) = -0.69; 95% Confidence Interval (CI), -1.01 to -0.37; p < 0.0001), Numerical Pain Scale (NRS) (SMD = -0.40; 95% CI, -0.87 to 0.06); p = 0.022), VAS + NRS (SMD = -1.32; 95% CI, -1.87 to -0.77; p < 0.0001) and function (Roland Morris Disability Questionnaire (RMDQ)) (SMD = -0.55; 95% CI, -0.83 to -0.27; p < 0.0001) after GPR treatment. Conclusion: This meta-analysis provides reliable evidence that GPR may be an effective method for treating LBP by decreasing pain and improving function, with strong evidence., This research was partially financially supported by the Erasmus+ Strategic Partnership for Higher Education Programme (Key Action 203) [Grant number: 2018-1-PL01-KA203-051055].

The aim of this study was to identify and to assess the best evidence currently available on the effectiveness of oral sensory-motor stimulation in preterm infants in the neonatal intensive care unit. We performed a systematic review following the Preferred Reporting Items for Systematic Reviews (PRISMA) statements. The search was conducted using the Pubmed, Web of Science (WOS), PEDro and Scopus databases. Clinical trials were reviewed and PEDro rating scale was used to assess the methodological quality of these studies. Results: 1267 studies were found and 11 were relevant and included in this review. Improvements were obtained in achieving independent feeding, maturation of the sucking pattern, transition to full feeding, motor function and length of hospital stay in most studies. Conclusions: there is evidence to support the benefits of the use of oral sensorimotor stimulation to achieve independent oral feeding in preterm infants, thereby reducing their stay in the Neonatal Intensive Care Unit.

Background: There are different therapeutic strategies such as physiotherapy and music therapy for the treatment of cerebral palsy. Intervention protocols using both therapies to unify the measurement of motor function have not been investigated. Aims and scope: To summarize the effects of the treatment of cerebral palsy through the use of both for the improvement of motor function, analyse the challenges encountered, and submit proposals for improving them. Methods: The systematic review was conducted following PRISMA guidelines and registered in the PROSPERO database (CRD42020162493). Clinical trials that described the results obtained in terms of motor function through physiotherapy and music therapy were included. Results: Eight clinical trials with 234 participants were considered with a significant improvement in motor function. Results of meta-analysis suggested improvements in gait velocity in favour of the control group for cerebral palsy (mean differences = 0.03; 95% confidence interval = 0.01, 0.04, p = 0.001; I-2 = 97%). However, high heterogeneity was identified in the meta-analysis due to the small number of studies included. Conclusions: The combination can be effective in subjects with cerebral palsy to improve motor function, although due to the diversity of studies analysed, it is complex to extrapolate results., This research was funded by the Department of Nursing and Physiotherapy (University of Cadiz).

BACKGROUND Augmented reality (AR) is a rapidly expanding technology; it comprises the generation of new images from digital information in the real physical environment of a person, which simulates an environment where the artificial and real are mixed. The use of AR in physiotherapy has shown benefits in certain areas of patient health. However, these benefits have not been studied as a whole. OBJECTIVE This study aims to ascertain the current scientific evidence on AR therapy as a complement to physiotherapy and to determine the areas in which it has been used the most and which variables and methods have been most effective. METHODS A systematic review registered in PROSPERO (International Prospective Register of Systematic Reviews) was conducted following PRISMA (Preferred Reporting Items for Systematic Reviews and Meta‐Analyses) recommendations. The search was conducted from July to August 2021 in the PubMed, PEDro, Web of Science, Scopus, and Cochrane Library scientific databases using the keywords augmented reality, physiotherapy, physical therapy, exercise therapy, rehabilitation, physical medicine, fitness, and occupational therapy. The methodological quality was evaluated using the PEDro scale and the Scottish Intercollegiate Guidelines Network scale to determine the degree of recommendation. The Cochrane Collaboration tool was used to evaluate the risk of bias. RESULTS In total, 11 articles were included in the systematic review. Of the 11 articles, 4 (36%) contributed information to the meta-analysis. Overall, 64% (7/11) obtained a good level of evidence, and most had a B degree of recommendation of evidence. A total of 308 participants were analyzed. Favorable results were found for the Berg Balance Scale (standardized mean change 0.473, 95% CI −0.0877 to 1.0338; z=1.65; P=.10) and the Timed Up and Go test (standardized mean change −1.211, 95% CI −3.2005 to 0.7768; z=−1.194; P=.23). CONCLUSIONS AR, in combination with conventional therapy, has been used for the treatment of balance and fall prevention in geriatrics, lower and upper limb functionality in stroke, pain in phantom pain syndrome, and turning in place in patients with Parkinson disease with freezing of gait. AR is effective for the improvement of balance; however, given the small size of the samples and the high heterogeneity of the studies, the results were not conclusive. Future studies using larger sample sizes and with greater homogeneity in terms of the devices used and the frequency and intensity of the interventions are needed. CLINICALTRIAL PROSPERO International Prospective Register of Systematic Reviews CRD42020180766; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=180766

Objective: To analyze the exercise programs used to prevent of acute hamstring injuries in eleven-a-side football players, and their effectiveness. (2) Methods: A systematic review (PRISMA) was conducted (2008–2020), including RCTs, that exclusively used physical exercises as a prevention method. (3) Results: Ten studies were selected considering 14 interventions, including nine different programs: FIFA11+ (11+), Harmoknee, eccentric Nordic Hamstring Exercise (NHE) exclusively, with eccentric exercises, with stretching or with proprioceptive, New Warm-up Program (NWP), Bounding Exercise Program (BEP), the only one with no positive results, and proprioceptive exercises. Incidence of injuries and strength were the most considered variables, both with favorable evidences. Programs including NHE, which assessed injury incidence, were always effective. The 11+ program was effective in injury incidence and strength; NWP was effective in balance, stability, and strength. (4) Conclusions: The exercise programs discussed were effective to prevent acute hamstring injuries in football players except BEP and partially Harmoknee. Exercises mostly used to reduce the risk of hamstring injuries are those of eccentric force due to its functionality, especially NHE. Only concentric contractions and isometric contractions obtained significant favorable results. The most complete and promising programs were 11+ (in injury incidence and strength) and NWP (strength, balance, and stability). NWP was the best in strength. Erasmus+ Strategic Partnership for Higher Education Program (Key Action 203), 2018-1-PL01-KA203-051055

Background Measuring weight bearing is an essential aspect of clinical care for lower limb injuries such as sprains or meniscopathy surgeries. This care often involves the use of forearm crutches for partial loads progressing to full loads. Therefore, feasible methods of load monitoring for daily clinical use are needed. Objective The main objective of this study was to design an innovative multifunctional desktop load-measuring software that complements GCH System 2.0–instrumented forearm crutches and monitors the applied loads, displaying real-time graphical and numerical information, and enabling the correction of inaccuracies through feedback technology during assisted gait. The secondary objective was to perform a preliminary implementation trial. Methods The software was designed for indoor use (clinics/laboratories). This software translates the crutch sensor signal in millivolts into force units, records and analyzes data (10-80 Hz), and provides real-time effective curves of the loads exerted on crutches. It covers numerous types of extrinsic feedback, including visual, acoustic (verbal/beeps), concurrent, terminal, and descriptive feedback, and includes a clinical and research use database. An observational descriptive pilot study was performed with 10 healthy subjects experienced in bilateral assisted gait. The Wilcoxon matched-pairs signed-rank test was used to evaluate the load accuracy evolution of each subject (ie, changes in the loads exerted on crutches for each support) among various walks, which was interpreted at the 95% confidence level. Results GCH Control Software was developed as a multifunctional desktop tool complementing GCH System 2.0–instrumented forearm crutches. The pilot implementation of the feedback mechanism observed 96/100 load errors at baseline (walk 0, no feedback) with 7/10 subjects exhibiting crutch overloading. Errors ranged from 61.09% to 203.98%, demonstrating heterogeneity. The double-bar feedback found 54/100 errors in walk 1, 28/100 in walk 2, and 14/100 in walk 3. The first walk with double-bar feedback (walk 1) began with errors similar to the baseline walk, generally followed by attempts at correction. The Wilcoxon matched-pairs signed-rank test used to evaluate each subject’s progress showed that all participants steadily improved the accuracy of the loads applied to the crutches. In particular, Subject 9 required extra feedback with two single-bar walks to focus on the total load. The participants also corrected the load balance between crutches and fluency errors. Three subjects made one error of load balance and one subject made six fluctuation errors during the three double-bar walks. The latter subject performed additional feedback with two balance-bar walks to focus on the load balance. Conclusions GCH Control Software proved to be useful for monitoring the loads exerted on forearm crutches, providing a variety of feedback for correcting load accuracy, load balance between crutches, and fluency. The findings of the complementary implementation were satisfactory, although clinical trials with larger samples are needed to assess the efficacy of the different feedback mechanisms and to select the best alternatives in each case.

BACKGROUND Measuring weight bearing is an essential aspect of clinical care for lower limb injuries such as sprains or meniscopathy surgeries. This care often involves the use of forearm crutches for partial loads progressing to full loads. Therefore, feasible methods of load monitoring for daily clinical use are needed. OBJECTIVE The main objective of this study was to design an innovative multifunctional desktop load-measuring software that complements GCH System 2.0–instrumented forearm crutches and monitors the applied loads, displaying real-time graphical and numerical information, and enabling the correction of inaccuracies through feedback technology during assisted gait. The secondary objective was to perform a preliminary implementation trial. METHODS The software was designed for indoor use (clinics/laboratories). This software translates the crutch sensor signal in millivolts into force units, records and analyzes data (10-80 Hz), and provides real-time effective curves of the loads exerted on crutches. It covers numerous types of extrinsic feedback, including visual, acoustic (verbal/beeps), concurrent, terminal, and descriptive feedback, and includes a clinical and research use database. An observational descriptive pilot study was performed with 10 healthy subjects experienced in bilateral assisted gait. The Wilcoxon matched-pairs signed-rank test was used to evaluate the load accuracy evolution of each subject (ie, changes in the loads exerted on crutches for each support) among various walks, which was interpreted at the 95% confidence level. RESULTS GCH Control Software was developed as a multifunctional desktop tool complementing GCH System 2.0–instrumented forearm crutches. The pilot implementation of the feedback mechanism observed 96/100 load errors at baseline (walk 0, no feedback) with 7/10 subjects exhibiting crutch overloading. Errors ranged from 61.09% to 203.98%, demonstrating heterogeneity. The double-bar feedback found 54/100 errors in walk 1, 28/100 in walk 2, and 14/100 in walk 3. The first walk with double-bar feedback (walk 1) began with errors similar to the baseline walk, generally followed by attempts at correction. The Wilcoxon matched-pairs signed-rank test used to evaluate each subject’s progress showed that all participants steadily improved the accuracy of the loads applied to the crutches. In particular, Subject 9 required extra feedback with two single-bar walks to focus on the total load. The participants also corrected the load balance between crutches and fluency errors. Three subjects made one error of load balance and one subject made six fluctuation errors during the three double-bar walks. The latter subject performed additional feedback with two balance-bar walks to focus on the load balance. CONCLUSIONS GCH Control Software proved to be useful for monitoring the loads exerted on forearm crutches, providing a variety of feedback for correcting load accuracy, load balance between crutches, and fluency. The findings of the complementary implementation were satisfactory, although clinical trials with larger samples are needed to assess the efficacy of the different feedback mechanisms and to select the best alternatives in each case.

Massive open online courses (MOOCs) provide accessible and engaging information for Physical Therapy and Occupational Therapy students. The objective of this research was to determine the usefulness in improving academic performance and empathy in health sciences undergraduates, and to test a hypothetical model through structural equation analysis. This research was carried out using a descriptive and quasi-experimental design. It was conducted in a sample of 381 participants: 176 used a MOOC and 205 did not. The results of the Student’s t-test showed statistically significant differences in academic performance between the groups in favor of those students who had realized the MOOC. Participants carried out an evaluation rubric after taking MOOC. Statistically significant differences in empathy were also obtained between the pre (X = 62.06; SD = 4.41) and post (X = 73.77; SD = 9.93) tests. The hypothetical model tested via structural equation modeling was supported by the results. Motivation for the MOOC explained 50% of the variance. The MOOC (participation and realization) explained 58% of academic performance, 35% of cognitive empathy and 48% of affective empathy. The results suggest an association between higher realization and participation in a MOOC and higher levels of academic performance, and cognitive and affective empathy., University of Malaga (UMA) for the Call for Educational Innovation Projects (PIE19-148), to the Call 2019-2021, Initiation Grant for Research from the UMA's Own Plan, in Modality A (Grade)

BackgroundThe important functional role the rotator cuff (RC) and biceps play in the shoulder, the close anatomical relationship between them and the high incidence of injuries require an appropriate multidisciplinary therapeutic approach after a rigorous assessment. The objective is to identify and analyze surgical interventions, whether or not followed by a postsurgical one, of associated dysfunctions on the RC and long head of the biceps (LHB) and their effectiveness in improving shoulder functionality.MethodsA systematic review based on PRISMA protocol was conducted using PubMed, Web of Science, PEDro, Scopus, CINAHL, and Dialnet until 22 April 2021. The main inclusion criteria were as follows: randomized clinical trials including subjects diagnosed with RC and LHB lesions who had surgical and/not post-surgical treatments. The methodological quality of trials was evaluated by the PEDro scale. Data were shown in 3 pre-established tables: (1)sample data, diagnostic methods, dysfunctions and injury frequency, interventions, outcome measures and results; (2)significance and effectiveness of interventions; and (3)comparison of the effectiveness of interventions.ResultsEleven studies were selected. The methodological quality of ten of them was assessed asgoodand oneexcellent(PEDro scale). All articles had surgical treatments and ten had postoperative management. All trials used arthroscopy and two open surgery too. Single-row, double-row and transosseous repair were used for RC lesions, while SLAP repair, tenotomy, and tenodesis were applied to LHB injuries. Measured parameters were functionality, pain, Popeye’s sign, strength, range of motion, satisfaction degree, biceps cramping, and quality of life. All approaches in general, surgical plus postsurgical, were always effective to the parameters measured in each study. Seven trials compared tenotomy and tenodesis: four of them obtained statistically significant differences in favor of tenodesis in Popeye’s sign, cramping, satisfaction degree, and/or forearm supination strength; and one, in favor of tenotomy in cramping. All studies measured functionality using functional assessment scales. The most widely used was the Constant Score.ConclusionsSurgical plus post-surgical interventions in associated dysfunctions on RC and LHB were effective. Tenodesis obtained better results than tenotomy in Popeye’s sign, satisfaction, and forearm supination strength. However, there was no difference regarding biceps cramping.

Background: Functional rating scales allow clinicians to document and quantify alterations and progression of recovery processes. There is neither awareness of numerous knee scales nor are they easy to find or compare to select the most suitable. Objectives: We aimed to compile validated knee functional rating tools and analyze the methodological qual ity of their validation studies. Also, we aimed to provide an operational document of the outcome measures addressing descriptions of parameters, implementations, instructions, interpretations and languages, to identify the most appropriate for future interventions. Methods: A systematic review involved a search of PubMed, Web of Science, CINAHL, Scopus, and Dialnet databases from inception through September 2020. The main inclusion criteria were available functional rat ing scales/questionnaires/indexes for knees and validation studies. Methodological quality was analyzed with the Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2) and COnsensus-based Standards for the selection of health Measurement Instruments Risk of Bias (COSMIN-RB). Results: We selected 73 studies. The studies investigated 41 knee rating tools (general, 46%, and specific, 54%) and 71 validations, including 29,742 individuals with knee disorders. QUADAS-2 obtained the best results in patient selection and index test (applicability section). COSMIN-RB showed the highest quality in construct validity (most analyzed metric property). The specific tools were mainly designed for prosthesis and patello femoral and anterior cruciate ligament injuries. More considered issues were specific function (93%), espe cially gait, pain/sensitivity (81%), and physical activity/sports (56%). Conclusions and implications: We conducted a necessary, useful, unlimited-by-time and feasible compilation of validated tools for assessing knee functional recovery. The methodological quality of the validations was limited. The best validations were for the Copenhagen Knee Range of Motion Scale in osteoarthritis and arthroplasties, Knee Outcome Survey Activities of Daily Living and Lysholm Knee Score for general knee dis orders and the Tegner Activity Score for anterior cruciate ligament injuries. The operational document for the scales provides necessary data to identify the most appropriate.

The aim of this study was to establish a relationship between nonstrabismic binocular dysfunction and baropodometric parameters. A total of 106 participants underwent binocular vision assessment by evaluating horizontal heterophoria, horizontal and vertical fusional vergence ranges, and vergence facility. Posturography was measured using the FreeMED baropodometric platform. Among the variables that the software calculates are foot surface, foot load, and foot pressure. Our results showed that in the participants with positive fusional vergence (PFV) (near) blur and recovery values outside the norm, there are statistically significant differences between the total foot area (p<0.05), forefoot area (p<0.05), forefoot load (p<0.05), and rearfoot load (p<0.05), in all of the cases of left foot vs. right foot. In the group of subjects who did not meet Sheard’s criterion (distance), that is, those with unstable binocular vision, there was a statistically significant difference (p<0.01) between maximum left and right foot pressure. In conclusion, our results establish a relationship between nonstrabismic binocular dysfunctions and some baropodometric parameters.

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).

Horizontal gaze palsy with progressive scoliosis (HGPPS) is a rare, inherited disorder characterized by a congenital absence of conjugate horizontal eye movements with progressive scoliosis developing in childhood and adolescence. Mutations in the Roundabout (ROBO3) gene located on chromosome 11q23–25 are responsible for the development of horizontal gaze palsy and progressive scoliosis. However, some studies redefined the locus responsible for this pathology to a 9-cM region. This study carried out a systematic review in which 25 documents were analyzed, following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) standards. The search was made in the following electronic databases from January 1995 to October 2019: PubMed, Scopus, Web of Science, PEDRO, SPORT Discus, and CINAHL. HGPPS requires a multidisciplinary diagnostic approach, in which magnetic resonance imaging might be the first technique to suggest the diagnosis, which should be verified by an analysis of the ROBO3 gene. This is important to allow for adequate ocular follow up, apply supportive therapies to prevent the rapid progression of scoliosis, and lead to appropriate genetic counseling.

Many studies have established a relationship between visual function and motor development in toddlers. This is the first report to study two-year-olds via an assessment of their visual and motor skills. The purpose of this study is to describe the possible changes that can occur between visual and motor systems in typical developing toddlers. A total of 116 toddlers were included in this observational, descriptive, and cross-sectional study. Their mean age was 29.57 &plusmn, 3.45 months. Motor development variables studied were dominant hand/foot, stationary, locomotion, object manipulation, grasping, visual motor integration percentiles, gross motor, fine motor, and total motor percentiles, and gross motor, fine motor, and total motor quotients. Visual development variables were assessed including visual acuity, refractive error, ocular alignment, motor fusion and suppression, ocular motility, and stereopsis. Our findings demonstrated that typical developing toddlers with slow gross motor development had higher exophoria and further near point of convergence values compared to toddlers with fast gross motor development (p &lt, 0.05). No statistically significant differences were found in visual acuity and stereopsis between slow and fast gross motor development toddlers.

Background: Epidemiological studies have suggested a pathophysiological relationship between obstructive sleep apnea syndrome (OSAS) and Alzheimer’s disease (AD). The aim of this study is to evaluate the treatment of obstructive sleep apnea with continuous positive airway pressure (CPAP) in AD and its relationship with neurocognitive function improvement. Methods: Systematic review conducted following PRISMA’s statements. Relevant studies were searched in MEDLINE, PEDro, SCOPUS, PsycINFO, Web of Science, CINAHL and SportDicus. Original studies in which CPAP treatment was developel in AD patients have been included. Results: 5 studies, 3 RCTs (Randomized controlled trials) and 2 pilot studies. In all RCTs the CPAP intervention was six weeks; 3 weeks of therapeutic CPAP vs. 3 weeks placebo CPAP (pCPAP) followed by 3 weeks tCPAP in patients with AD and OSA. The two pilot studies conducted a follow-up in which the impact on cognitive impairment was measured. Conclusions: CPAP treatment in AD patients decreases excessive daytime sleepiness and improves sleep quality. There are indications that cognitive deterioration function measured with the Mini Mental Scale decreases or evolves to a lesser extent in Alzheimer’s patients treated with CPAP. Caregivers observe stabilization in disease progression with integration of CPAP. More research is needed on the topic presented.

Rheumatology is a broad research area with an extensive background in scientific publications. Thus, the present study aims to identify the highly cited papers in Rheumatology research field, analyzing some aspects such as the documents distribution by years, journals, authors, institutions and countries. Furthermore, a conceptual evolution and a co-word analysis have been performed. In order to carry out this study, the H-Classics methodology, based on widely used H-index, has been used. A total of 317 highly cited papers have been detected from a total amount of 103.175 documents (articles and reviews) indexed in the Rheumatology category of the Web of Science database, from the period 1945–2016. As a result, it is obtained that Arthritis and Rheumatism is the journal with the highest number of documents, with more than half of detected documents. Professor Emery, from the University of Leeds (UK), and professor Felson, from the Boston University (USA), are the authors with more highly cited papers. The University of California (USA) and the University of Stanford (USA) are the main institutional contributors. USA is the leading producer, with more than half of the highly cited papers, but it is interesting to highlight the position reached by Peoples R. China, Mexico and, South Africa when an adjustment index based in the GDP per capita is applied. Osteo-arthritis and monoclonal antibody are the leader topics of this set of documents. The present study shows a useful insight into the development and evolution of the Rheumatology research field, revealing actors that have made the most significant research contribution to its development.

The aim of this study was to establish whether there is a relationship between conditions of accommodative visual dysfunctions and cervical complaints. Fifty-two participants were included. Variables were accommodative amplitude, positive and negative relative accommodation (NRA), accommodative response, and accommodative facility. Subjects were classified as accommodative insufficiency, accommodative excess, or normal. Neck complaints were measured with the Neck Disability Index, the Visual Analogue Scale, and by cervical range of motion, deep flexor muscle activation score, and performance index. We found the following significant relationships: between NRA and both performance index and left-side bending; accommodative amplitude right-eye with right-side bending and with left-side bending; accommodative amplitude left-eye with right-side bending; and accommodative facility left-eye with both performance index and left-side bending. In accommodative amplitude right-eye, aIl participants showed significant values and greater than those with accommodative excess. In both groups, performance index values were decreased. Greater pain and lower right-rotation were found in participants with accommodative excess than in those with accommodative insufficiency. We conclude that accommodative dysfunctions are related to low performance index, decreased range of motion, as well as greater neck pain.

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.

Background Augmented reality (AR) is a rapidly expanding technology; it comprises the generation of new images from digital information in the real physical environment of a person, which simulates an environment where the artificial and real are mixed. The use of AR in physiotherapy has shown benefits in certain areas of patient health. However, these benefits have not been studied as a whole. Objective This study aims to ascertain the current scientific evidence on AR therapy as a complement to physiotherapy and to determine the areas in which it has been used the most and which variables and methods have been most effective. Methods A systematic review registered in PROSPERO (International Prospective Register of Systematic Reviews) was conducted following PRISMA (Preferred Reporting Items for Systematic Reviews and Meta‐Analyses) recommendations. The search was conducted from July to August 2021 in the PubMed, PEDro, Web of Science, Scopus, and Cochrane Library scientific databases using the keywords augmented reality, physiotherapy, physical therapy, exercise therapy, rehabilitation, physical medicine, fitness, and occupational therapy. The methodological quality was evaluated using the PEDro scale and the Scottish Intercollegiate Guidelines Network scale to determine the degree of recommendation. The Cochrane Collaboration tool was used to evaluate the risk of bias. Results In total, 11 articles were included in the systematic review. Of the 11 articles, 4 (36%) contributed information to the meta-analysis. Overall, 64% (7/11) obtained a good level of evidence, and most had a B degree of recommendation of evidence. A total of 308 participants were analyzed. Favorable results were found for the Berg Balance Scale (standardized mean change 0.473, 95% CI −0.0877 to 1.0338; z=1.65; P=.10) and the Timed Up and Go test (standardized mean change −1.211, 95% CI −3.2005 to 0.7768; z=−1.194; P=.23). Conclusions AR, in combination with conventional therapy, has been used for the treatment of balance and fall prevention in geriatrics, lower and upper limb functionality in stroke, pain in phantom pain syndrome, and turning in place in patients with Parkinson disease with freezing of gait. AR is effective for the improvement of balance; however, given the small size of the samples and the high heterogeneity of the studies, the results were not conclusive. Future studies using larger sample sizes and with greater homogeneity in terms of the devices used and the frequency and intensity of the interventions are needed. Trial Registration PROSPERO International Prospective Register of Systematic Reviews CRD42020180766; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=180766

New accessible learning methods delivered through mobile mixed reality are becoming possible in education, shifting pedagogy from the use of two dimensional images and videos to facilitating learning via interactive mobile environments. Augmented reality (AR) is a technology that allows to incorporate virtual data (text, links, audio, video, multimedia, etc) from an object in the real world. For this, we need a device (mobile, tablet, laptop, etc.) with a camera, a software that processes the information, augmented reality activators and a screen where to show the real image together with the recovered data. This is especially important in medical and health education, where the required knowledge acquisition is typically much more experiential, self-directed, and hands-on than in many other disciplines. This project intends to apply the AR with videos to develop appropriate materials for Physiotherapy Degree students of Cadiz University. For this, we will take advantage of the videos about the procedures explained in class that were carried out in the courses 2016-17 and 2017-18 in the teacher innovation projects (sol-201500054614-tra y sol-201700083802-tra). The videos that are most interesting were used to create practice sheets for the subject, so that students can see the video during practice as many times as they want and they can even continue to consult the material after classes to improve their manual ability with physical therapy modalities. The idea is to create some cards of the subject to be able to compare the sensations and the abilities of the students in the techniques learned with AR and in which those cards have not been developed. Finally, students will be surveyed to find out their satisfaction with the learning method included in the subject. The number of students who participated in the research was 45. The questionnaire used to assess student satisfaction was Teaching Satisfaction Questionnaire (CSD) framed in the evaluation tool 'eValua', designed by the Continuing Professional Development Project of the Andalusian Agency for Healthcare Quality (Spain). The CSD is presented as a reliable and valid tool for measuring satisfaction with continuing education in health. The global valuation with the activity obtained a value of 8.62, considered very high. After the analysis, we can confirm how the use of emerging technologies could be an appropriate and useful practice for students to play an active role in their education and being able to develop higher order skills and digital competences for the implementation of AR tools from an educational and didactic perspective.

Accommodation disorders and nonstrabismic binocular dysfunctions affect patients' binocular system and visual performance. These visual disorders could be associated with musculoskeletal discomfort in the neck and shoulder area. The purpose of this systematic review and meta-analysis was to ascertain the relationship between visual system disorders and the musculoskeletal system of the neck. The review protocol is available in PROSPERO (CRD42018112771). All articles selected examined the relationship between neck conditions (chronic neck pain and whiplash) and the visual system in adult populations. Studies with optometric or physiotherapeutic measurements were included. Bias risk was evaluated with the modified Cochrane Collaboration Tool and Study Quality Assessment Tool. To provide complete quality assessment evidence, the authors applied the GRADEpro Guideline Development Tool. The literature search was conducted in November 2018 and yielded 745 studies among all the databases. Out of these studies, 21 were finally included. Most of the studies presented a moderate methodological quality. Only one high-quality trial was found. Based on a qualitative assessment, our systematic review and meta-analysis revealed that all included studies established a relationship between the visual system and musculoskeletal system of the neck. However, the methods for the measurement of the visual system lacked uniformity.

This article belongs to the Special Issue Spondyloarthritis: From Pathophysiology to Treatment., The aim of this study was to determine the role of global postural reeducation for people with ankylosing spondylitis. We compared the effects of treatments on pain, dysfunction (using the Bath Ankylosing Spondylitis Disease Activity Index and Bath Ankylosing Spondylitis Functional Index), range of motion, and chest expansion in a specific population aged over 18 years old with ankylosing spondylitis. We performed a systematic review and meta-analysis following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) statements. The search was conducted using the PubMed, Physiotherapy Database (PEDro), Scientific Electronic Library Online (SciELO), and Web of Science (WoS) databases. Clinical trials and systematic reviews/meta-analysis were reviewed. Results: 154 studies were found. Finally, four were included. Conclusions: global postural reeducation is beneficial for ankylosing spondylitis, but no more so than other conventional treatments, except for spinal mobility, where Global Postural Reeducation demonstrated an advantage.

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.

The aim of this study is to establish a relationship between non-strabismic binocular dysfunction and neck pain. One hundred twelve participants underwent binocular vision assessment by evaluating horizontal heterophoria, horizontal and vertical fusional vergence ranges and vergence facility. The subjects were classified into two groups: binocular anomalies and normal binocular function. Neck complaints were measured with the Neck Disability Index, visual analogue scale, cervical range of motion, deep-flexor muscle activation score (AS) and performance index (PI). Our results showed that participants with low AS had significantly altered values of lateral phoria (near) (mean = -6.99 SD ± 6.96 PD) and PFV (near) blur (mean = 9.49 SD ± 5.45 PD) against those who presented normal AS (lateral phoria (near) mean = -3.64 SD ± 6.37 PD; PFV (near) blur mean = 12.84 SD ± 6.20 PD). In addition, participants with NFV (near) recovery outside the norm had a significantly lower right side-bending (mean = 35.63 SD ± 8.35 PD) than those within the standard (mean = 39.64 SD ± 9 PD). The subjects with binocular vision impairment showed a diminished response to the deep cervical musculature, with low AS and PI, as well as a tendency to suffer from cervicalgia of more than three months’ evolution and a lower range of motion.

Microbiology is an area with a high research production, classified in different branches. Thus, it is difficult to identify research trends without many backgrounds. The present paper aims to apply bibliometric methods to identify the highly cited papers that contribute to the Microbiology development. Furthermore, a science mapping analysis allows discovering the main thematic areas covered by those detected papers. From the 572 153 papers (articles and reviews) indexed in the Web of Science Microbiology category (1900-2017), a total of 645 highly cited papers were detected. Concerning the main scientific producers in Microbiology, Applied and Environmental Microbiology as a journal, R. Knight from the University of Colorado (USA) as an author and the USA as a country are the most productive actors. Nevertheless, taking into account the gross domestic product per capita, China and Spain are remarkable countries. Furthermore, according to the relative priority index (RPI), Denmark, Belgium, Spain and The Netherlands are the countries that make a higher scientific effort in this field. About the co-word analysis, several important themes were detected, such as Next Generation Sequencing, Gene, Escherichia Coli or Gene Expression. Concerning these results, this work supposes a framework on which to base future research.

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.

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.