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Introduction: Medical prescriptions have traditionally been focused on aerobic exercise. However, an increasing number of authors are pointing towards strength training as the healthiest exercise modality. The purpose of this study is to assess whether physicians increase their knowledge as well as their confidence to prescribe strength training after attending a physical training course., Materials and Methods: A prospective cohort study of 160 physicians was conducted, 80 physicians out of the 160 attended a physical training course, whereas the remaining 80 physicians did not. Personal and professional data was collected, as well as data regarding the type of exercise they were practising or prescribing and the confidence and knowledge for their prescription. Finally, differences between the two groups and the impact of attending the course where analysed., Results: Both groups were homogeneous in gender, age, medical speciality and practice of physical exercise, with very low rates of strength training and prescription for both groups. It was established that the group attending the course acquired knowledge and confidence for prescribing strength training. Moreover, this group considered that strength training was the exercise modality which should be encouraged (P<.001)., Conclusions: Education in strength training for physicians by means of a theoretical-practical course increases knowledge and confidence for its prescription., (Copyright © 2021 Sociedad Española de Rehabilitación y Medicina Física. Publicado por Elsevier España, S.L.U. All rights reserved.)

Objective: Post-COVID syndrome can impact against every sphere of daily live. The objective of this work was to detect the factors correlated with a better or worse physical recovery four months after hospital discharge from a hospitalization in ICU due to COVID-19., Methods: Prospective descriptive study of 125 patients valued by the Rehabilitation Service during hospitalization in ICU, from March 12 th to December 31 st , 2020. Data from 76 patients was analysed with clinical follow up after 1, 2 and 4 months of hospital discharge. Variables on personal, hospitalary, functional symptoms/signals and physical recovery were analysed with mean ± standard deviation, counting (percentage), T-student test and Fisher test., Results: After one month, fatigue was observed in 60 (80%) patients and dyspnoea in 47 (62%). After two months, fatigue in 37 (55%), dyspnoea in 25 (33%), shoulder pain in 33 (43%), average QuickDASH was 22.7 (11.3-50), Sit-to-Stand Test in 30 seconds 11.5 (10-13) and 6-minute walk test 390 meters (326-445). In the fourth month, 25 (53%) had returned to work and had an average of the physical recovery of 79.1%±18.3%. There was no correlation between physical recovery ≥75% and the first month data, but there certainly was a correlation between some second month variables, such as fatigue (p=0.001), dyspnoea (p=0.035), QuickDASH (p=0.001) and 6-minute walk test (p=0.021)., Conclusions: Symptoms (fatigue and dyspnoea) and functional scales (QuickDASH and 6-minute walk test) after 2 months predict a better/worsen physical recovery after 4 months of hospital discharge., Competing Interests: Disclosure The authors report no conflicts of interest in this work.

Objective: The aim of this study was to analyse both the impact of the pandemic and clinical and teaching organisation in Spanish Physical Medicine and Rehabilitation Departments during the COVID-19 pandemic., Methods: A survey was conducted of the tutors of rehabilitation departments. The questionnaire contained 31 questions divided into 6 parts about the following: general information on the department, adaptation of rehabilitation departments to the COVID pandemic, clinical work of rehabilitation physicians, the approach to rehabilitation in COVID patients, and the effects of the pandemic on the health and teaching activity of rehabilitation physicians during this period., Results: A total of 54 responses were obtained. Almost half of the departments cancelled face-to-face medical consultations (40%) and 48% of the treatment rooms were turned into COVID beds. In 30 hospitals (55.6%), the physicians worked in COVID units. Most of the rehabilitation departments developed both graphic and audiovisual material with exercises, referral protocols and guidelines for the rehabilitation management and treatment of COVID 19 patients. Half of the departments reported some anxiety symptoms in medical staff. Tutorial work has been cancelled (40.7%) or reduced (35.2%)., Conclusions: The organisation of Spanish rehabilitation departments in response to the COVID pandemic has been very similar throughout the country. The response of these departments to the healthcare crisis has revealed the versatility of rehabilitation physicians., (Copyright © 2020 Sociedad Española de Rehabilitación y Medicina Física. Publicado por Elsevier España, S.L.U. All rights reserved.)

Neuropathic pain impairs quality of life in affected individuals and poses a challenge to clinicians due to the complexity of its treatment and frequent therapeutic failures. We present 4clinical cases of chronic neuropathic pain (LANSS ≥ 19), refractory to conservative treatment (meralgia paraesthetica, post-surgical pain and 2surgical scars). Subcutaneous botulinum toxin type A was infiltrated periodically over the painful area. All patients experienced subjective improvement in pain and improvement measured by the visual analogic scale. Pain relief started at 5-21 days and continued up to 1.5-3 months, and up to 9 months in one patient. Pain that reappeared was of lower intensity in 3patients and was reduced in area in 2patients., (Copyright © 2019 Sociedad Española de Rehabilitación y Medicina Física. Publicado por Elsevier España, S.L.U. All rights reserved.)

Introduction: Lipoedema is a chronic disorder of adipose tissue, characterised by disproportionate fat deposits in the lower limbs and pain with preservation of the feet. The condition usually only affects women. Diagnosis is clinical and mainly by exclusion. This disorder is little known and underdiagnosed. The objective of this article was to perform a non-systematic review of the literature on lipoedema, its diagnostic criteria and proposed treatments., Methodology: A literature search was carried out from January 2012 to January 2018, in the following databases: Pubmed, Scopus, Medline, Web of Science and CINAHL., Selection of Studies: A total of 12 articles were included, of which 10 were reviews, one was a cross-sectional study and another was a case series., Conclusions: Diagnosis of lipoedema is mainly clinical and through exclusion of other disorders. There is no consensus on its treatment, but treatment focuses on attempting to minimise symptoms and prevent disease progression and the disability it may generate., (Copyright © 2018 Elsevier España, S.L.U. y SERMEF. All rights reserved.)

Objective: To identify characteristics of early arthritis units, that may be associated with better referral eficiency., Methods: A national survey of the 36 early arthritis units (EAU) in Spanish Rheumatology Units in 2004 (SERAP project). Survey collected information about general practitioners (GP) educational program to improve knowledge and practical skills of early arthritis, networking and feed-back system and referral efficiency. EAU were classified in two groups according to 25 and 50% of inappropriate referral process, respectively., Results: Thirty four of the 36 (94%) EAU, answered the survey. GP were trained in only 1 medical meeting in the primary care clinic, with one or more rheumatologists responsible of GP education. Fourteen of the 34 EAU (42.4%) regularly interacted with GP and only 20 (39.4%) contacted the GP who were responsible for the wrong referral process. Median lag time for referral to the Rheumatology out-patient clinic, was 73 days (15-365 days). The percentage of wrongly referred patients was between 0 and 80% (38% ± 21). Only 10 EAU (27.8%) referred patients appropriately according to the most strict criteria (25% of inappropriate referral) and 27 EAU (75%), according to 50% of inappropriate referral criteria., Conclusions: Only two aspects of the EAU implementation strategy were associated with better referral efficiency: 1) interaction with the GP responsible of the inappropriate referral process and 2) a lower median lag time for referral to the Rheumatology out-patient clinic., (2010 Elsevier España, S.L. All rights reserved.)

Objective: To compare the concept of patient with pluripathology (PP) with the index of comorbidity of Charlson (IC) respect to the resources use and prognosis of hospitalized patients., Patients and Methods: An observational prospective study of 207 consecutively hospitalized patients in an internal medicine unit was conducted. The PP, a variant of PP with three or more criteria (PP3), IC and IC fit to the age (ICE) were determined, and their relation with the consumption of resources (emergency attentions, programmed consultations of specialties and episodes of hospitalization in the last year, length of stay, own procedures, other specialty procedures and consulting) and prognosis (hospital mortality, significant functional deterioration and rehospitalization) were stayed., Results: The frequency of PP and PP3 was 40.6 and 16.9%, respectively. The median of the IC and ICE score were 2 (0-7) and 4 (0-11), respectively. We found the following independent relations: IC of 3 or greater with the rehospitalization and the length of stay; ICE of 5 or greater with mortality; PP3 with mortality, rehospitalization and emergency visits, hospitalizations and consultations in the last year; the categories B and F of PP with hospitalizations in the last year; the category D of PP with consultations in the last year; and the association of categories A, B and C with mortality and hospitalizations in the last year. PP was not related in an independent form with any variable., Conclusion: The IC and the concept of PP do not identify the same hospitalized patient population. Modifications of the PP definition, like PP3, or the analysis of the different clinical categories of PP and their associations, could improve the utility of this concept.