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Introduction: Gamification consists of the use of games in non-playful contexts. It is widely employed in the motor rehabilitation of neurological diseases, but mainly in adult patients. The objective of this review was to describe the use of gamification in the rehabilitation of children and adolescents with neuromotor impairment. Methods: We performed a systematic review of clinical trials published to date on the MEDLINE (PubMed), Scielo, SCOPUS, Dialnet, CINAHL, and PEDro databases, following the PRISMA protocol. The methodological quality of the studies identified was assessed using the PEDro scale. Results: From a total of 469 studies, 11 clinical trials met the inclusion criteria. We analysed the gamification systems used as part of the rehabilitation treatment of different neuromotor conditions in children and adolescents. Cerebral palsy was the most frequently studied condition (6 studies), followed by developmental coordination disorder (3), neurological gait disorders (1), and neurological impairment of balance and coordination (1). Conclusion: The use of gamification in rehabilitation is helpful in the conventional treatment of neuromotor disorders in children and adolescents, with increased motivation and therapeutic adherence being the benefits with the greatest consensus among authors. While strength, balance, functional status, and coordination also appear to improve, future research should aim to determine an optimal dosage. Resumen: Introducción: La ludificación consiste en emplear el juego en contextos no lúdicos. Su uso en la rehabilitación motora de patologías neurológicas está muy extendido, pero sobre todo en pacientes adultos. El objetivo de esta revisión fue describir el uso de la ludificación en los tratamientos de rehabilitación en niños y adolescentes con afectación neuromotora. Métodos: Se realizó una revisión sistemática de ensayos clínicos en diferentes bases de datos: Medline (a través de Pubmed), Scielo, SCOPUS, Dialnet, Cinahl y PEDro de la literatura científica publicada hasta la fecha siguiendo el protocolo PRISMA. La calidad metodológica de los estudios identificados se evaluó a través de la escala PEDro. Resultados: De un total de 469 estudios localizados se seleccionaron 11 ensayos clínicos que cumplieron los criterios de inclusión. Se analizaron los sistemas de ludificación utilizados como parte del tratamiento rehabilitador en distintas afecciones neuromotoras en niños y adolescentes. La Parálisis Cerebral fue la afección con mayor número de estudios (n = 6) seguida del Trastorno del Desarrollo de la Coordinación (n = 3). También se estudió la alteración de la marcha por causa neurológica (n = 1) y la alteración del equilibrio y coordinación por causa neurológica (n = 1). Conclusión: El uso de la ludificación en rehabilitación aporta beneficios al tratamiento convencional de las alteraciones neuromotoras en niños y adolescentes siendo el incremento de la motivación y adherencia terapéutica los que mayor consenso han alcanzado entre autores. Fuerza, equilibrio, funcionalidad y coordinación son otras variables analizadas que, si bien sugieren mejoras, necesitarían futuras investigaciones para determinar una óptima dosificación.

Resumen: Introducción: El test Rey-Osterrieth Complex Figure (ROCF) y el Free and Cued Selective Reminding Test (FCSRT) son pruebas ampliamente utilizadas en la práctica clínica. El ROCF es de gran utilidad para la exploración de la percepción visual, la praxis constructiva y la memoria visuoespacial. El FCSRT evalúa aprendizaje y memoria verbal. Objetivo: En el presente estudio, que forma parte del proyecto de obtención de datos normativos españoles en adultos jóvenes (proyecto NEURONORMA jóvenes), se aportan datos normativos ajustados por edad y escolaridad para ambos test mediante la aplicación de regresiones lineales. Material y métodos: Se incluyó a 179 participantes sanos de entre 18 y 49 años de edad. Se aportan tablas para convertir las puntuaciones brutas en escalares, así como tablas de ajuste por los factores sociodemográficos. Resultados: Los resultados obtenidos muestran influencia de la escolaridad en diversas variables de memoria y en la copia de la figura. La edad únicamente afecta el rendimiento en memoria visuoespacial y el efecto del género es despreciable. Conclusiones: Las referencias obtenidas son de gran utilidad clínica para la evaluación neuropsicológica de población adulta joven española. Abstract: Introduction: The Rey-Osterrieth Complex Figure (ROCF) and the Free and Cued Selective Reminding Test (FCSRT) are widely used in clinical practice. The ROCF assesses visual perception, constructional praxis, and visuo-spatial memory. The FCSRT assesses verbal learning and memory. Objective: In this study, as part of the Spanish normative studies project in young adults (NEURONORMA young adults), we present age- and education-adjusted normative data for both tests obtained by using linear regression techniques. Material and methods: The sample consisted of 179 healthy participants ranging in age from 18 to 49 years. We provide tables for converting raw scores to scaled scores in addition to tables with scores adjusted by socio-demographic factors. Results: The results showed that education affects scores for some of the memory tests and the figure-copying task. Age was only found to have an effect on the performance of visuo-spatial memory tests, and the effect of sex was negligible. Conclusions: The normative data obtained will be extremely useful in the clinical neuropsychological evaluation of young Spanish adults. Palabras clave: Datos normativos, Edad, Escolaridad, Memoria, Praxis constructiva, Keywords: Normative data, Age, Educational level, Memory, Constructional praxis

Introduction: The Rey–Osterrieth Complex Figure (ROCF) and the Free and Cued Selective Reminding Test (FCSRT) are widely used in clinical practice. The ROCF assesses visual perception, constructional praxis, and visuo-spatial memory. The FCSRT assesses verbal learning and memory. Objective: In this study, as part of the Spanish normative studies project in young adults (NEURONORMA young adults), we present age- and education-adjusted normative data for both tests obtained by using linear regression techniques. Materials and methods: The sample consisted of 179 healthy participants ranging in age from 18 to 49 years. We provide tables for converting raw scores to scaled scores in addition to tables with scores adjusted by socio-demographic factors. Results: The results showed that education affects scores for some of the memory tests and the figure-copying task. Age was only found to have an effect on the performance of visuo-spatial memory tests, and the effect of sex was negligible. Conclusions: The normative data obtained will be extremely useful in the clinical neuropsychological evaluation of young Spanish adults. Resumen: Introducción: El test Rey-Osterrieth Complex Figure (ROCF) y el Free and Cued Selective Reminding Test (FCSRT) son pruebas ampliamente utilizadas en la práctica clínica. El ROCF es de gran utilidad para la exploración de la percepción visual, la praxis constructiva y la memoria visuoespacial. El FCSRT evalúa aprendizaje y memoria verbal. Objetivo: En el presente estudio, que forma parte del proyecto de obtención de datos normativos españoles en adultos jóvenes (proyecto NEURONORMA jóvenes), se aportan datos normativos ajustados por edad y escolaridad para ambos test mediante la aplicación de regresiones lineales. Material y métodos: Se incluyó a 179 participantes sanos de entre 18 y 49 años de edad. Se aportan tablas para convertir las puntuaciones brutas en escalares, así como tablas de ajuste por los factores sociodemográficos. Resultados: Los resultados obtenidos muestran influencia de la escolaridad en diversas variables de memoria y en la copia de la figura. La edad únicamente afecta el rendimiento en memoria visuoespacial y el efecto del género es despreciable. Conclusiones: Las referencias obtenidas son de gran utilidad clínica para la evaluación neuropsicológica de población adulta joven española. Keywords: Normative data, Age, Educational level, Memory, Constructional praxis, Palabras clave: Datos normativos, Edad, Escolaridad, Memoria, Praxis constructiva

Introduction: The Visual Object and Space Perception Battery (VOSP) and Judgment of Line Orientation tests (JLO) are used in clinical practice to assess visuoperceptual and visuospatial abilities. Objective: In this study, as part of the Spanish normative studies project in young adults (NEURONORMA young adults), we present normative data for a short version of the VOSP test and for the JLO test. Material and methods: The sample consisted of 179 participants who are cognitively normal and range in age from 18 to 49 years. Tables are provided to convert raw scores to scaled scores. Education- and sex-adjusted scores were obtained by applying linear regression techniques. Results: Our results show that education and sex only affect scores on the JLO test, and that age has no effect. Conclusions: The normative data obtained will be extremely useful in the clinical evaluation of young Spanish adults. Resumen: Introducción: La Visual Object and Space Perception Battery (VOSP) y el Judgment of Line Orientation (JLO) son pruebas utilizadas para explorar habilidades visuoperceptivas y visuoespaciales. Objetivo: En el presente estudio, como parte de los estudios normativos españoles del proyecto NEURONORMA jóvenes, se presentan datos normativos para una versión abreviada de la VOSP y el JLO. Material y métodos: La muestra está formada por 179 participantes, cognitivamente normales, de entre 18 y 49 años de edad. Se aportan tablas para convertir las puntuaciones brutas en escalares y tablas con los ajustes pertinentes por escolaridad y género a partir de regresiones lineales. Resultados: Los resultados obtenidos muestran la influencia de la escolaridad y el género únicamente en el JLO, y nulo efecto de la edad. Conclusiones: Las normas obtenidas aportan datos de gran utilidad clínica para la evaluación de población adulta joven española. Keywords: Normative data, Age, Educational level, Space perception, Visual pattern recognition, Palabras clave: Datos normativos, Edad, Escolaridad, Percepción espacial, Reconocimiento visual

Resumen: Introducción: La Visual Object and Space Perception Battery (VOSP) y el Judgment of Line Orientation (JLO) son pruebas utilizadas para explorar habilidades visuoperceptivas y visuoespaciales. Objetivo: En el presente estudio, como parte de los estudios normativos españoles del proyecto NEURONORMA jóvenes, se presentan datos normativos para una versión abreviada de la VOSP y el JLO. Material y métodos: La muestra está formada por 179 participantes, cognitivamente normales, de entre 18 y 49 años de edad. Se aportan tablas para convertir las puntuaciones brutas en escalares y tablas con los ajustes pertinentes por escolaridad y género a partir de regresiones lineales. Resultados: Los resultados obtenidos muestran la influencia de la escolaridad y el género únicamente en el JLO, y nulo efecto de la edad. Conclusiones: Las normas obtenidas aportan datos de gran utilidad clínica para la evaluación de población adulta joven española. Abstract: Introduction: The Visual Object and Space Perception Battery (VOSP) and Judgment of Line Orientation tests (JLO) are used in clinical practice to assess visuoperceptual and visuospatial abilities. Objective: In this study, as part of the Spanish normative studies project in young adults (NEURONORMA young adults), we present normative data for a short version of the VOSP test and for the JLO test. Material and methods: The sample consisted of 179 participants who are cognitively normal and range in age from 18 to 49 years. Tables are provided to convert raw scores to scaled scores. Education- and sex-adjusted scores were obtained by applying linear regression techniques. Results: Our results show that education and sex only affect scores on the JLO test, and that age has no effect. Conclusions: The normative data obtained will be extremely useful in the clinical evaluation of young Spanish adults. Palabras clave: Datos normativos, Edad, Escolaridad, Percepción espacial, Reconocimiento visual, Keywords: Normative data, Age, Educational level, Space perception, Visual pattern recognition

Introduction: The Stroop Color–Word Interference Test (Stroop) measures cognitive flexibility, selective attention, cognitive inhibition and information processing speed. The Tower of London-Drexel University version test (TOLDX) assesses higher-order problem solving and executive planning abilities. Objective: In this study, as part of the Spanish normative studies project in young adults (NEURONORMA young adults), we present normative data for the Stroop and TOLDX tests. Material and methods: The sample consisted of 179 participants who are cognitively normal and range in age from 18 to 49 years. Tables are provided to convert raw scores to scaled scores. Scores adjusted for sociodemographic factors were obtained by applying linear regression techniques. Results: No effects were found for age and sex in either test. Educational level impacted most of the Stroop test variables and some of the TOLDX scores (total moves score and total initiation time score). Conclusions: The norms obtained will be extremely useful in the clinical evaluation of young Spanish adults. Resumen: Introducción: El Stroop Color-Word Interference Test (Stroop) se utiliza para explorar la flexibilidad mental, la atención selectiva, la inhibición cognitiva y la velocidad de procesamiento de la información. El test Tower of London-Drexel University version (TOLDX) es útil para explorar la habilidad para resolver problemas y la planificación. Objetivo: En el presente estudio, como parte de los estudios normativos españoles del proyecto NEURONORMA jóvenes, se presentan datos normativos para el Stroop y la TOLDX. Material y métodos: La muestra está formada por 179 participantes, cognitivamente normales, de entre 18 y 49 años de edad. Se aportan tablas para convertir las puntuaciones brutas en escalares. Se aplican regresiones lineales para calcular los ajustes por factores sociodemográficos. Resultados: Se observó un efecto nulo de la edad y el género en ambas pruebas. La escolaridad influyó en la mayoría de variables del Stroop y en algunas medidas de la TOLDX (movimientos totales y tiempo de latencia). Conclusiones: Los datos normativos obtenidos son de gran utilidad clínica para la evaluación de población adulta joven española. Keywords: Normative data, Age, Educational level, Interference, Problem-solving, Palabras clave: Datos normativos, Edad, Escolaridad, Interferencia, Resolución de problemas

Resumen: Introducción: El Stroop Color-Word Interference Test (Stroop) se utiliza para explorar la flexibilidad mental, la atención selectiva, la inhibición cognitiva y la velocidad de procesamiento de la información. El test Tower of London-Drexel University version (TOLDX) es útil para explorar la habilidad para resolver problemas y la planificación. Objetivo: En el presente estudio, como parte de los estudios normativos españoles del proyecto NEURONORMA jóvenes, se presentan datos normativos para el Stroop y la TOLDX. Material y métodos: La muestra está formada por 179 participantes, cognitivamente normales, de entre 18 y 49 años de edad. Se aportan tablas para convertir las puntuaciones brutas en escalares. Se aplican regresiones lineales para calcular los ajustes por factores sociodemográficos. Resultados: Se observó un efecto nulo de la edad y el género en ambas pruebas. La escolaridad influyó en la mayoría de variables del Stroop y en algunas medidas de la TOLDX (movimientos totales y tiempo de latencia). Conclusiones: Los datos normativos obtenidos son de gran utilidad clínica para la evaluación de población adulta joven española. Abstract: Introduction: The Stroop Color-Word Interference Test (Stroop) measures cognitive flexibility, selective attention, cognitive inhibition and information processing speed. The Tower of London-Drexel University version test (TOLDX) assesses higher-order problem solving and executive planning abilities. Objective: In this study, as part of the Spanish normative studies project in young adults (NEURONORMA young adults), we present normative data for the Stroop and young adults TOLDX tests. Material and methods: The sample consisted of 179 participants who are cognitively normal and range in age from 18 to 49 years. Tables are provided to convert raw scores to scaled scores. Scores adjusted for sociodemographic factors were obtained by applying linear regression techniques. Results: No effects were found for age and sex in either test. Educational level impacted most of the Stroop test variables and some of the TOLDX scores (Total Moves score and Total Initiation Time score). Conclusions: The norms obtained will be extremely useful in the clinical evaluation of young Spanish adults. Palabras clave: Datos normativos, Edad, Escolaridad, Interferencia, Resolución de problemas, Keywords: Normative data, Age, Educational level, Interference, Problem-solving

Resumen: Introducción: Los test de fluencia verbal se utilizan con frecuencia en la práctica clínica con el fin de explorar el lenguaje y las funciones ejecutivas. Objetivo: En el presente estudio, como parte de los estudios normativos españoles del proyecto NEURONORMA jóvenes, se aportan datos normativos ajustados por edad y escolaridad para 3 tareas de fluencia semántica (animales, frutas y verduras, y utensilios de cocina), 3 tareas de fluencia formal (palabras que empiezan por P, M, y R), 3 tareas de fluencia de letra excluida (palabras que no contienen A, E, y S) y una tarea de fluencia de verbos. Material y métodos: La muestra está formada por 179 participantes, cognitivamente normales, de entre 18 y 49 años de edad. Se aportan tablas para convertir las puntuaciones brutas en escalares y tablas para realizar los ajustes pertinentes por edad y escolaridad a partir de regresiones lineales. Resultados: Los resultados obtenidos muestran la influencia de la escolaridad para la mayoría de los test de fluencia verbal, escaso efecto de la edad y mínimo efecto del género. Conclusiones: Las normas obtenidas aportan datos de gran utilidad clínica para la evaluación de población adulta joven española. Abstract: Introduction: Lexical fluency tests are frequently used in clinical practice to assess language and executive function. Objective: As part of the Spanish normative studies project in young adults (NEURONORMA young adults project), we provide age- and education-adjusted normative data for 3 semantic fluency tasks (animals, fruits and vegetables, and kitchen tools), three formal lexical fluency tasks (words beginning with P, M and R), three excluded-letter fluency tasks (words excluding A, E and S) and a verb fluency task. Material and methods: The sample consisted of 179 participants who are cognitively normal and range in age from 18 to 49 years. Tables are provided to convert raw scores to scaled scores. Age- and education-adjusted scores are provided by applying linear regression techniques. Results: The results show that education impacted most of the verbal fluency test scores, with no effects related to age and only minimal effects related to sex. Conclusions: The norms obtained will be extremely useful in the clinical evaluation of young Spanish adults. Palabras clave: Datos normativos, Edad, Escolaridad, Test de lenguaje, Vocabulario, Keywords: Normative data, Age, Educational level, Language test, Vocabulary

Introduction: Lexical fluency tests are frequently used in clinical practice to assess language and executive function. Objective: As part of the Spanish normative studies project in young adults (NEURONORMA young adults), we provide age- and education-adjusted normative data for 3 semantic fluency tasks (animals, fruits and vegetables, and kitchen tools), three formal lexical fluency tasks (words beginning with P, M and R), three excluded-letter fluency tasks (words excluding A, E and S) and a verb fluency task. Material and methods: The sample consisted of 179 participants who are cognitively normal and range in age from 18 to 49 years. Tables are provided to convert raw scores to scaled scores. Age- and education-adjusted scores are provided by applying linear regression techniques. Results: The results show that education impacted most of the verbal fluency test scores, with no effect related to age and only minimal effects related to sex. Conclusions: The norms obtained will be extremely useful in the clinical evaluation of young Spanish adults. Resumen: Introducción: Los test de fluencia verbal se utilizan con frecuencia en la práctica clínica con el fin de explorar el lenguaje y las funciones ejecutivas. Objetivo: En el presente estudio, como parte de los estudios normativos españoles del proyecto NEURONORMA jóvenes, se aportan datos normativos ajustados por edad y escolaridad para 3 tareas de fluencia semántica (animales, frutas y verduras, y utensilios de cocina), 3 tareas de fluencia formal (palabras que empiezan por P, M, y R), 3 tareas de fluencia de letra excluida (palabras que no contienen A, E, y S) y una tarea de fluencia de verbos. Material y métodos: La muestra está formada por 179 participantes, cognitivamente normales, de entre 18 y 49 años de edad. Se aportan tablas para convertir las puntuaciones brutas en escalares y tablas para realizar los ajustes pertinentes por edad y escolaridad a partir de regresiones lineales. Resultados: Los resultados obtenidos muestran la influencia de la escolaridad para la mayoría de los test de fluencia verbal, escaso efecto de la edad y mínimo efecto del género. Conclusiones: Las normas obtenidas aportan datos de gran utilidad clínica para la evaluación de población adulta joven española. Keywords: Normative data, Age, Educational level, Language test, Vocabulary, Palabras clave: Datos normativos, Edad, Escolaridad, Test de lenguaje, Vocabulario

Introduction: The Boston Naming Test (BNT) and the Token Test (TT) are frequently used in clinical practice to assess naming and comprehension. Objective: The aim of this paper is to present normative data for the BNT and for the TT as part of the NEURONORMA young adults project. Material and methods: A total of 179 Spanish healthy subjects from 18 to 49 years old were evaluated. Tables to convert raw scores to scaled scores are provided. Age- and education- adjusted scores are obtained by applying linear regressions. Results: The results show an effect of education in both tests, and a minimal effect of age and sex. Conclusions: The normative data obtained will be useful in the clinical evaluation of young Spanish adults. Resumen: Introducción: El Boston Naming Test (BNT) y el Token Test (TT) son pruebas ampliamente utilizadas en la práctica clínica para explorar la denominación y la comprensión. Objetivo: En este artículo se presentan los datos normativos del BNT y el TT obtenidos en el proyecto normativo español NEURONORMA jóvenes. Material y métodos: La muestra está formada por 179 sujetos sanos de entre 18 y 49 años de edad. Se aportan tablas para convertir las puntuaciones brutas en escalares y tablas con los ajustes pertinentes por edad y escolaridad obtenidas a partir de regresiones lineales. Resultados: Los resultados obtenidos muestran influencia de la escolaridad en ambos tests, pero un mínimo efecto de la edad y del género. Conclusiones: Las normas obtenidas aportan datos de gran utilidad clínica para la evaluación de población adulta joven española. Keywords: Age, Comprehension, Educational status, Language tests, Naming, Normative data, Palabras clave: Comprensión, Datos normativos, Denominación, Edad, Escolaridad, Test de lenguaje

Resumen: Introducción: El Boston Naming Test (BNT) y el Token Test (TT) son pruebas ampliamente utilizadas en la práctica clínica para explorar la denominación y la comprensión. Objetivo: En este artículo se presentan los datos normativos del BNT y el TT obtenidos en el proyecto normativo español NEURONORMA jóvenes. Material y métodos: La muestra está formada por 179 sujetos sanos de entre 18 y 49 años de edad. Se aportan tablas para convertir las puntuaciones brutas en escalares y tablas con los ajustes pertinentes por edad y escolaridad obtenidas a partir de regresiones lineales. Resultados: Los resultados obtenidos muestran influencia de la escolaridad en ambos tests, pero un mínimo efecto de la edad y del género. Conclusiones: Las normas obtenidas aportan datos de gran utilidad clínica para la evaluación de población adulta joven española. Abstract: Introduction: The Boston Naming Test (BNT) and the Token Test (TT) are frequently used in clinical practice to assess naming and comprehension. Objective: The aim of this paper is to present normative data for the BNT and for the TT as part of the NEURONORMA young adults Project. Material and methods: A total of 179 Spanish healthy subjects from 18 to 49 years old were evaluated. Tables to convert raw scores to scaled scores are provided. Age- and education- adjusted scores are obtained by applying linear regressions. Results: The results show an effect of education in both tests, and a minimal effect of age and sex. Conclusions: The normative data obtained will be useful in the clinical evaluation of young Spanish adults. Palabras clave: Comprensión, Datos normativos, Denominación, Edad, Escolaridad, Test de lenguaje, Keywords: Age, Comprehension, Educational status, Language tests, Naming, Normative data

Introduction: Verbal and visuospatial span, Letter-Number Sequencing (LNS), Trail Making Test (TMT), and Symbol Digit Modalities Test (SDMT) are frequently used in clinical practice to assess attention, executive functions and memory.In the present study, as part of the Spanish normative studies of NEURONORMA young adults Project, normative data adjusted by age and education are provided for Digits, Corsi Block-Tapping Task, LNS, TMT, and SDMT. Subjects and methods: The sample consisted of 179 participants from 18 to 49 years old, who were cognitively normal. Tables to convert raw scores to scaled scores are provided. Age and education adjusted scores are provided by applying linear regressions. Results: Education affected scores in most of the attention tests; age was found to be related to the visuospatial span and to speed of visuomotor tracking, and there was no relationship as regards sex. Conclusions: The current normative data should provide clinically useful data for evaluating young Spanish adults. Resumen: Introducción: El span verbal y visuoespacial, el test Letter-Number Sequencing (LNS), el Trail Making Test (TMT) y el Symbol Digit Modalities Test (SDMT) son pruebas ampliamente utilizadas en la práctica clínica para explorar la atención, las funciones ejecutivas y la memoria. Objetivo: En el presente estudio, como parte de los estudios normativos españoles del Proyecto NEURONORMA jóvenes, se aportan datos normativos ajustados por edad y escolaridad para los Dígitos, los Cubos de Corsi, la LNS, el TMT y el SDMT. Sujetos y métodos: La muestra está formada por 179 participantes, cognitivamente normales, de entre 18 y 49 años de edad. Se aportan tablas para convertir las puntuaciones brutas en escalares y tablas con los ajustes pertinentes por edad y escolaridad a partir de una regresión lineal. Resultados: Se observa influencia de la escolaridad en la mayoría de los tests de atención, así como efecto de la edad en el span visuoespacial y en la velocidad de rastreo visuomotor. El efecto del género es mínimo. Conclusiones: Las normas obtenidas aportan datos de gran utilidad clínica para la evaluación de población adulta joven española. Keywords: Age, Attention, Educational status, Normative data, Working memory, Palabras clave: Atención, Datos normativos, Edad, Escolaridad, Memoria de trabajo

Resumen: Introducción: El span verbal y el visuoespacial, el test Letter-Number Sequencing, el Trail Making Test y el Symbol Digit Modalities Test son pruebas ampliamente utilizadas en la práctica clínica para explorar la atención, las funciones ejecutivas y la memoria. Objetivo: En el presente estudio, como parte de los estudios normativos españoles del Proyecto NEURONORMA jóvenes, se aportan datos normativos ajustados por edad y escolaridad para los dígitos, los cubos de Corsi, la Letter-Number Sequencing, el Trail Making Test y el Symbol Digit Modalities Test. Material y métodos: La muestra está formada por 179 participantes, cognitivamente normales, de entre 18 y 49 años de edad. Se aportan tablas para convertir las puntuaciones brutas en escalares y tablas con los ajustes pertinentes por edad y escolaridad a partir de una regresión lineal. Resultados: Se observa influencia de la escolaridad en la mayoría de los tests de atención, así como efecto de la edad en el span visuoespacial y en la velocidad de rastreo visuomotor. El efecto del género es mínimo. Conclusiones: Las normas obtenidas aportan datos de gran utilidad clínica para la evaluación de población adulta joven española. Abstract: Introduction: Verbal and visuospatial span, Letter-Number Sequencing, Trail Making Test, and Symbol Digit Modalities Test are frequently used in clinical practice to assess attention, executive functions and memory. Objective: In the present study, as part of the Spanish normative studies of NEURONORMA young adults Project, normative data adjusted by age and education are provided for digits, Corsi Block-Tapping Task, Letter-Number Sequencing, Trail Making Test, and Symbol Digit Modalities Test. Material and methods: The sample consisted of 179 participants from 18 to 49 years old, who were cognitively normal. Tables to convert raw scores to scaled scores are provided. Age and education adjusted scores are provided by applying linear regressions. Results: Education affected scores in most of the attention tests; age was found to be related to the visuospatial span and to speed of visuomotor tracking, and there was no relationship as regards sex. Conclusions: The data obtained will be useful in the clinical evaluation of young Spanish adults. Palabras clave: Atención, Datos normativos, Edad, Escolaridad, Memoria de trabajo, Keywords: Attention, Normative data, Age, Educational status, Working memory

Introduction: In clinical neuropsychology, normative data are necessary to relate the performance of a subject to a reference group. These normative data should be collected from a pertinent population taking into account sociodemographic and cultural factors. Objective: This paper describes the methods and sample characteristics of a series of Spanish normative studies on young adults (NEURONORMA young adults project, NNy). The normative information was based on a series of selected, commonly used, neuropsychological tests covering attention, language, visual-perceptual abilities, constructional tasks, memory, and executive functions. Material and methods: A sample of 179 cognitively normal subjects from 18 to 49 years was studied. Demographics, socio-cultural, and medical data were collected. The statistical procedure used in the normative studies is described. Results: Sociodemographic, family background, health habits, medical history and use of drugs are presented. Conclusions: The use of these norms should improve neuropsychological diagnostic accuracy in young Spanish subjects. These data may also be of considerable use for comparisons with other normative studies. Resumen: Introducción: En neuropsicología clínica es necesario disponer de datos normativos con el fin de relacionar el comportamiento de un sujeto con un grupo de referencia. Estos datos normativos deben extraerse de una población pertinente, teniendo en cuenta las características propias de cada cultura y el efecto de las variables sociodemográficas. Objetivo: Describir los métodos y las características de la muestra de una serie de estudios normativos españoles en población adulta joven (Proyecto NEURONORMA jóvenes). Se incluyen tests neuropsicológicos de uso extendido para valorar atención, lenguaje, habilidades visuoperceptivas, habilidades visuoconstructivas, memoria, y funciones ejecutivas. Material y métodos: Se estudió una muestra de 179 sujetos cognitivamente normales, con un rango de edad de 18 a 49 años. Se recogieron datos demográficos, socioculturales y médicos. Se describe el procedimiento estadístico utilizado en el estudio normativo. Resultados: Se presentan los datos sociodemográficos, los antecedentes familiares, los hábitos de salud, los antecedentes médicos y el uso de fármacos. Conclusiones: El uso de estas normas será de gran utilidad para el diagnóstico neuropsicológico en sujetos españoles jóvenes, así como para la comparación con otros estudios normativos. Keywords: Normative data, Age, Educational status, Neuropsychological test, Reference values, Palabras clave: Datos normativos, Edad, Escolaridad, Tests neuropsicológicos, Valores de referencia

Resumen: Introducción: En neuropsicología clínica es necesario disponer de datos normativos con el fin de relacionar el comportamiento de un sujeto con un grupo de referencia. Estos datos normativos deben extraerse de una población pertinente, teniendo en cuenta las características propias de cada cultura y el efecto de las variables sociodemográficas. Objetivo: Describir los métodos y las características de la muestra de una serie de estudios normativos españoles en población adulta joven (Proyecto NEURONORMA jóvenes). Se incluyen tests neuropsicológicos de uso extendido para valorar atención, lenguaje, habilidades visuoperceptivas, habilidades visuoconstructivas, memoria, y funciones ejecutivas. Material y métodos: Se estudió una muestra de 179 sujetos cognitivamente normales, con un rango de edad de 18 a 49 años. Se recogieron datos demográficos, socioculturales y médicos. Se describe el procedimiento estadístico utilizado en el estudio normativo. Resultados: Se presentan los datos sociodemográficos, los antecedentes familiares, los hábitos de salud, los antecedentes médicos y el uso de fármacos. Conclusiones: El uso de estas normas será de gran utilidad para el diagnóstico neuropsicológico en sujetos españoles jóvenes, así como para la comparación con otros estudios normativos. Abstract: Introduction: In clinical neuropsychology, normative data are necessary to relate the performance of a subject to a reference group. These normative data should be collected from a pertinent population taking into account sociodemographic and cultural factors. Objective: This paper describes the methods and sample characteristics of a series of Spanish normative studies on young adults (NEURONORMA young adults Project). The normative information was based on a series of selected, commonly used, neuropsychological tests covering attention, language, visual-perceptual abilities, constructional tasks, memory, and executive functions. Material and methods: A sample of 179 cognitively normal subjects from 18 to 49 years was studied. Demographics, socio-cultural, and medical data were collected. The statistical procedure used in the normative studies is described. Results: Sociodemographic, family background, health habits, medical history and use of drugs are presented. Conclusions: The use of these norms should improve neuropsychological diagnostic accuracy in young Spanish subjects. These data may also be of considerable use for comparisons with other normative studies. Palabras clave: Datos normativos, Edad, Escolaridad, Tests neuropsicológicos, Valores de referencia, Keywords: Normative data, Age, Educational status, Neuropsychological test, Reference values

The purpose of this work is to evaluate the absorbed dose to the eye lenses due to the cone beam computed tomography (CBCT) system used to accurately position the patient during head-and-neck image guided procedures. The on-board imaging (OBI) systems (v.1.5) of Clinac iX and TrueBeam (Varian) accelerators were used to evaluate the imparted dose to the eye lenses and some additional points of the head. All CBCT scans were acquired with the Standard-Dose Head protocol from Varian. Doses were measured using thermoluminescence dosimeters (TLDs) placed in an anthropomorphic phantom. TLDs were calibrated at the beam quality used to reduce their energy dependence. Average dose to the lens due to the OBI systems of the Clinac iX and the TrueBeam were 0.71  ±  0.07 mGy/CBCT and 0.70  ±  0.08 mGy/CBCT, respectively. The extra absorbed dose received by the eye lenses due to one CBCT acquisition with the studied protocol is far below the 500 mGy threshold established by ICRP for cataract formation (ICRP 2011 Statement on Tissue Reactions). However, the incremental effect of several CBCT acquisitions during the whole treatment should be taken into account. [ABSTRACT FROM AUTHOR]

This paper reviews the evidence base for an in-hospital 12-month training program in neurodiagnostic technology utilizing two educational tracks: Electroencephalography (EEG) or Polysomnography (PSG), employing standardized didactic courses via the ASET - The Neurodiagnostic Society EEGCore Curriculum EEG 200-211 and the A-STEP online sleep self-study modules by the American Academy of Sleep Medicine (AASM). Specifically, we examine the purpose, strategy, and outcomes for the training program that was established in 2016 at Ann & Robert H. Lurie Children's Hospital of Chicago to support mission sustaining service lines. In addition, we report the results from a series of student course evaluations and an independent assessment of the program by ABRET Neurodiagnostic Credentialing and Accreditation through the application for programmatic recognition for EEG. Finally, we present a set of recommendations for organizations looking to develop a neurodiagnostic technology training program.

Background : Young children with spinal muscular atrophy type 1 (SMA1) have limited independent mobility and participation that may lead to cognitive development delays. Implementing early powered mobility in interventions may help them to learn self-initiated movement, play, and having fun to participate in natural settings. The aim of this study is to evaluate the effectiveness of an early power mobility intervention for increasing participation, functional ability, and quality of life in young children with SMA1. Methods : AMEsobreRuedas is a randomized waiting list controlled clinical trial. A sample of 24 children (10 months-5 years old, with SMA1) will be randomly allocated to two groups. The experimental group will perform a family-centered intervention with powered mobility for 16 weeks in their natural environment: a 12-week-structured program three times a week; and a 4-week follow-up with free use of the powered mobility device. The control group (waiting list) will keep their routine and will receive the same intervention after the experimental group. Five assessments will be carried out at baseline and weeks 4, 8, 12, and 16. Primary outcomes are participation (YC-PEM); functional ability (PEDI-CAT); and quality of life (PedsQL-Neuromuscular module). Results : It is expected that this study will provide further knowledge about the positive impact of powered mobility for the analyzed variables. Moreover, family engagement in the intervention and establishment of functional goals may help to add valuable information about real needs in future research. Conclusions : Early powered mobility could increase the opportunities for children with SMA1 to learn to move independently and participate in their natural environment.

The human-animal relationship is crucial for animal welfare. Gentle handling enhances pigs' comfort while rough handling causes fear and stress. This study examined how different human-animal relationship qualities affect the behavior and heart rate variability (linear and non-linear parameters) of 36 nursery pigs. Over six weeks, pigs experienced positive ( n = 12), minimal ( n = 12), or negative ( n = 12) human handling. Their responses to handlers were then assessed in an experimental arena with four phases: habituation, exposure to the handler standing and sitting, and forced interaction. Pigs subjected to negative handling exhibited increased fear-related behaviors, spending less time in contact with the handler. They also exhibited heightened stress responses, with greater LF/HF ratio and Lmean values compared with positively handled pigs. Conversely, gently handled pigs displayed affiliative behaviors, accepting more strokes, and higher parasympathetic activation, indicated by greater RMSSD/SDNN and SampEn values, suggesting a more positive affective state. Minimally handled pigs exhibited some behavioral similarities to gently handled pigs, although physiological data indicated that the interaction was likely more rewarding for the gently handled pigs. These results emphasize the impact of human-animal relationships on pig welfare and highlight the value of incorporating non-linear heart rate variability parameters in such evaluations.

Background : There has been an increase in people with disabilities who require continuous care, which often falls to informal carers (ICs). Stroke is one of the conditions where ICs are most needed. Therefore, it is necessary for ICs to improve their caregiving skills and self-care capacity. Telehealth (TH) can facilitate them. The aim of this systematic review is to summarize the evidence of the effects of interventions on ICs of stroke patients. Methods : The search was conducted in Pubmed, Scopus, Web of Science, CINALH, Psychology and Behavioral Sciences Collection, and APA PsycInfo. Key search terms included "stroke", "informal caregiver" and "telemedicine". Only randomised clinical trials were included. Results : A total of 2031 articles were found in the databases, 476 were screened and 19 clinical trials met the eligibility criteria. Different TH programmes have evaluated many outcomes related to physical and emotional health. The TH tools included phone, videophone, web-based interventions, and social media. The most investigated outcome was depression; although contradictory results were found, the TH may have helped to prevent an increase in depressive symptoms. There were inconsistent results on the caregiving burden and the preparedness of the IC. However, TH has positive effects on the health of the ICs, reducing the number of unhealthy days, anxiety, task difficulty perception, and improving psychological health. Conclusions : TH may be a useful tool to improve the abilities and health of ICs of SS. No adverse effects have been reported. More quality studies evaluating the effects of telemedicine on the ICs of stroke survivors, as well as the most appropriate doses, are needed.

Pregnancy is one of the most complex periods in a woman's life, not only because of the biological changes involved but also because of the psychological aspects. Stress during pregnancy refers to the concerns and distress that arise during pregnancy and that can be assessed by means of psychological and physiological scales. The aim of this study was to analyse prenatal stress and to evaluate its consequences on the health of both the mother and the foetus. A descriptive longitudinal study was carried out on a sample of 398 pregnant women being followed up during their entire pregnancy, who gave birth at the Punta de Europa University Hospital in Algeciras (Spain) between September 2021 and August 2023. The Prenatal Distress Questionnaire (PDQ) was used, as well as serum cortisol levels in each trimester of pregnancy and birth experience using the Childbirth Experience Questionnaire in its validated Spanish version, CEQ-E. Demographic and obstetric variables were included. One of the main findings was that experiencing more stress in late pregnancy had a negative impact on obstetric outcomes. Women who had higher levels of prenatal distress had higher blood cortisol levels and increased risk of having a caesarean section at delivery. A significant negative correlation was also found between stress and Apgar test values in the first minute of life. It is concluded that interventions promoted by the health system that provide comprehensive prenatal care contribute to decreased stress as perceived by these pregnant women, thus reducing the risk of maternal and foetal morbidity.

Objectives: Pregnancy is a stage in which different physical and psychological changes take place that can affect the sexuality of the couple. The aim of the study is to identify how the physical and psychological changes derived from pregnancy affect the sexual desire of women and men. Methods: A systematic review of the literature was carried out in five databases, from which a total of 16,126 documents were obtained. After applying the PRISMA selection criteria, a total of 19 documents were selected. Results: Levels of sexual desire fluctuate during pregnancy, being the second trimester of gestation the period in which desire is at its highest and in which physical limitations and emotional changes decrease. Women have lower levels of sexual desire in the first trimester, while men have the lowest levels of desire in the third trimester. Conclusion: Pregnancy is a stage marked by physiological and psychological changes that modify several areas, including sexuality. Healthcare professionals should promote a healthy sexuality, avoiding the appearance of fears or sexual dysfunctions caused by the changes that occur during pregnancy., Competing Interests: The authors declare that they do not have any conflicts of interest., (Copyright © 2024 Fernández-Carrasco, Batugg-Chaves, Ruger-Navarrete, Riesco-González, Palomo-Gómez, Gómez-Salgado, Rodriguez Diaz, Vázquez-Lara, Fagundo-Rivera and Vázquez-Lara.)

Aims: To review the literature on the effects of vestibular training on motor function and balance in children and youth with cerebral palsy., Methods: Eight databases (MEDLINE-PubMed, PEDro, Cochrane Library, OTSeeker, Web of Science, Scopus Database, CINAHL and SPORTDiscus.) were searched up to May 15th, 2023. Studies comparing vestibular training with other types of interventions. The DerSimonian and Laird method was employed using random effects models to calculate the pooled estimate of the effect size with confidence intervals of 95%. The risk of bias was assessed with the Cochrane Collaboration's tool and the Grading of Recommendations Assessment, Development and Evaluation approach was used to judge the certainty of the evidence for all outcomes., Results: Eight studies were included comprising 226 participants with cerebral palsy. The meta-analyses demonstrated significant standardized mean differences in favor of vestibular training program compared to other technique(s) for Gross Motor Function Measure (-0.471; 95% confidence intervals: -0.919 to -0.023) and balance (-0.546; 95% confidence intervals: -0.916 to -0.176)., Conclusions: Vestibular training has potential benefits in the short-term as a therapeutic approach for improving gross motor function and the balance in children and youth with cerebral palsy, but further research is needed.

Introduction: Subjective cognitive decline (SCD) is characterized by subjective cognitive concerns without objective cognitive impairment and is considered a risk factor for cognitive decline and dementia. However, most SCD patients will not develop neurodegenerative disorders, yet they may suffer from minor psychiatric, neurological, or somatic comorbidities. The aim of the present study was to provide a taxonomy of the heterogeneous SCD entity and to conduct a preliminary validation using data from a memory clinic sample., Methods: Participants were fifty-five SCD individuals consecutively recruited at the Geneva Memory Center. Based on clinical reports, they were classified into three clinically pre-defined subgroups: (i) those with psychological or psychiatric comorbidities (Psy), (ii) those with somatic comorbidities (SomCom), (iii) and those with no apparent cause (NAC). Baseline demographics, clinical, cognitive, and biomarker differences among the SCD subgroups were assessed. Longitudinal cognitive changes (average 3 years follow-up) were modeled using a linear mixed model., Results: Out of the 55 SCD cases, 16 were SomCom, 18 Psy, and 21 NAC. 47% were female, mean age was 71 years. We observed higher frequency of APOE ε4 carriers in NAC (53%) compared to SomCom (14%) and Psy (0%, p = 0.023) and lower level of plasma Aβ42 in NAC (6.8 ± 1.0) compared to SomCom (8.4 ± 1.1; p = 0.031). SomCom subjects were older (74 years) than Psy (67 years, p = 0.011), and had greater medial temporal lobe atrophy (1.0 ± 1.0) than Psy (0.2 ± 0.6) and NAC (0.4 ± 0.5, p = 0.005). SomCom has worse episodic memory performances (14.5 ± 3.5) than Psy (15.8 ± 0.4) and NAC (15.8 ± 0.7, p = 0.032). We observed a slightly steeper, yet not statistically significant, cognitive decline in NAC (β = -0.48) compared to Psy (β = -0.28) and SomCom (β = -0.24)., Conclusions: NAC features a higher proportion of APOE ε4 carriers, lower plasma Aβ42 and a trend towards steeper cognitive decline than SomCom and Psy. Taken together, these findings suggest that NACs are at higher risk of cognitive decline due to AD. The proposed clinical taxonomy might be implemented in clinical practice to identify SCD at higher risk. However, such taxonomy should be tested on an independent cohort with a larger sample size., (© 2024 S. Karger AG, Basel.)

Introduction: Gamification consists of the use of games in non-playful contexts. It is widely employed in the motor rehabilitation of neurological diseases, but mainly in adult patients. The objective of this review was to describe the use of gamification in the rehabilitation of children and adolescents with neuromotor impairment., Methods: We performed a systematic review of clinical trials published to date on the MEDLINE (PubMed), Scielo, SCOPUS, Dialnet, CINAHL, and PEDro databases, following the PRISMA protocol. The methodological quality of the studies identified was assessed using the PEDro scale., Results: From a total of 469 studies, 11 clinical trials met the inclusion criteria. We analysed the gamification systems used as part of the rehabilitation treatment of different neuromotor conditions in children and adolescents. Cerebral palsy was the most frequently studied condition (6 studies), followed by developmental coordination disorder (3), neurological gait disorders (1), and neurological impairment of balance and coordination (1)., Conclusion: The use of gamification in rehabilitation is helpful in the conventional treatment of neuromotor disorders in children and adolescents, with increased motivation and therapeutic adherence being the benefits with the greatest consensus among authors. While strength, balance, functional status, and coordination also appear to improve, future research should aim to determine an optimal dosage., (Copyright © 2023. Published by Elsevier España, S.L.U.)

Introduction: Children with infantile hemiplegia with low or very low bimanual functional performance have great impediments to spontaneously use their affected upper limb, which affects their performance of day-to-day activities and their quality of life., Objective: To determine whether the order of application and the dose of modified constraint-induced movement therapy within a combined (hybrid) protocol influences the results of bimanual functional performance of the affected upper limb and the quality of life of children with congenital hemiplegia (5 to 8 years old) with low/very low bimanual functional performance., Design: Single-blinded randomized controlled trial., Participants: Twenty-one children with congenital hemiplegia (5 to 8 years old) were recruited from two public hospitals and an infantile hemiplegia association in Spain., Interventions: The experimental group (n = 11) received 100 hours of intensive therapies for the affected upper limb: 80 hours of modified constraint-induced movement therapy and 20 hours of bimanual intensive therapy. The control group (n = 10) received the same dose with 80 hours of bimanual intensive therapy and 20 hours of modified constraint-induced movement therapy. The protocol was provided 2 hours per day, 5 days per week, for 10 weeks., Outcome Measures: The primary outcome was bimanual functional performance, measured with the Assisting Hand Assessment, and the second outcome was quality of life, measured with the Pediatric Quality of Life Inventory Cerebral-Palsy module (PedsQL v. 3.0, CP module). Four assessments were performed: Weeks 0, 4, 8, and 10., Results: The experimental group obtained an increase of 22 assisting hand assessment (AHA) units at week 8 with the application of modified constraint-induced movement, in contrast with the control group, which obtained an increase of 3.7 AHA units after bimanual intensive therapy. At week 10, the control group showed its greatest increase in bimanual functional performance, with 10.6 AHA units after modified constraint-induced movement therapy. Regarding quality of life, the greatest improvement occurred after modified constraint-induced movement, with 13.1 points in the experimental group (80 hours) and 6.3 points in the control group (20 hours). The protocol interaction was statistically significant for bimanual functional performance (p = .018) and quality of life (p = .09)., Conclusions: Modified constraint-induced movement therapy is more beneficial than bimanual intensive therapy for improving upper limb functioning and quality of life in children with congenital hemiplegia showing low/very low bimanual performance., Gov Identifier: NCT03465046., (© 2023 The Authors. PM&R published by Wiley Periodicals LLC on behalf of American Academy of Physical Medicine and Rehabilitation.)

Objective: To develop a Spanish version of the Rett Syndrome Motor Evaluation Scale (RESMES) for the locomotor function of Rett Syndrome (RTT) using a transcultural methodology., Methods: The RESMES was cross-culturally adaptated and validated in the Spanish language (RESMES-sp). This study was divided into two well-differentiated phases: 1) a cross-cultural translation and adaptation; 2) psychometric characteristics analysis of the RESMES-sp (reliability, test-retest, construct validity, criteria validity, error measurements). For criteria validity, PAINAD questionnaire, the scoliosis values and PedsQL™, were used., Results: A total of 63 girls and women diagnosed with RTT participated in this validation study. The total value of the RESMES-sp correlates significantly with all its dimensions, with the correlation value oscillating between 0.645 and 0.939. The correlation value with PAINAD ranges between 0.439 and 0.805; the scoliosis values ranges between 0.245 and 0.564; with PedsQOL™ questionnaire, the correlation values range between 0.273 and 0.663 for the PedsQL™ dimensions, and between 0.447 and 0.648 for the total value of PedsQOL™ questionnaire. The reliability values of Crombach's alpha ranged between 0.897 and 0.998 for the intra-observer analyses and between 0.904 and 0.998 for the inter-observer reliability. The SEM showed a value of 2,829, while the MDC90 showed a value of 6601. The Exploratory Factor Analysis showed 6 factors and values of variance of 86.163%., Conclusions: The Spanish version of the RESMES is a reliable and valid tool for the functional assessment and follow-up of patients with RTT., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2023 Published by Elsevier Ltd on behalf of European Paediatric Neurology Society.)

Purpose: This study aimed to examine motor performance and somatosensory processing of unilateral cerebral palsy (UCP) children in both the less-affected hand and the more-affected hand. This study is also aimed at analysing the somatosensory proccessing in the more-affected hand in relation to age and damaged hemisphere., Materials and Methods: Forty-seven children aged from 6 to 15 years (UCP = 23; TD = 24) were recruited. Grip strength, pinch strength, Box and Block Test and Jebsen Taylor Hand Function Test were used to analyse motor performance. A comprehensive somatosensory assessment battery was included: tactile registration, unilateral, bilateral and spatio-temporal perception, haptic recognition, texture perception, proprioception, pressure pain threshold and functional sensitivity., Results: UCP children exhibited lower performance in all aspects of motor performance measured in both the less-affected hand and the more-affected hand, except grip strength in the less-affected hand. Significant differences were found for all tests included in the somatosensory assessment in both the less-affected hand and the more-affected hand, except unilateral perception tests in the less-affected hand., Conclusions: UCP children present difficulties in motor performance and somatosensory processing not only in the more-affected hand, but also in the less-affected hand. Somatosensation may be a critical driver of functional performance.Implications for rehabilitationThe less-affected hand of children with unilateral cerebral palsy should be included in both assessment and intervention programmes.Somatosensory processing should be assessed through a comprehensive battery, both in the less-affected hand and in the more-affected hand of unilateral cerebral palsy children.Somatosensory treatment must be taken into account if functional performance in the activities of daily living of unilateral cerebral palsy children is to be improved.

(1) Objective: to identify and review existing infodemiological studies on nutritional disorders applied to occupational health and to analyse the effect of the intervention on body mass index (BMI) or alternatively body weight (BW); (2) Methods: This study involved a critical analysis of articles retrieved from MEDLINE (via PubMed), Embase, Cochrane Library, PsycINFO, Scopus, Web of Science, Latin American, and Caribbean Health Sciences Literature (LILACS) and Medicina en Español (MEDES) using the descriptors "Nutrition Disorders, "Occupational Health" and "Infodemiology", applying the filters "Humans" and "Adult: 19+ years". The search was conducted on 29 May 2021; (3) Results: a total of 357 references were identified from the bibliographic database searches; after applying the inclusion and exclusion criteria, a total of 11 valid studies were obtained for the review. Interventions could be categorised into (1) interventions related to lifestyle, physical activity, and dietary changes through education programmes, (2) interventions associated with lifestyle, physical activity, and dietary changes through the use of telemonitoring systems or self-help applications, (3) interventions tied to lifestyle, physical activity, and dietary changes through control and/or social network support groups, and (4) interventions linked to changes in the work environment, including behavioural change training and work environment training tasks. The meta-analysis demonstrated that the heterogeneity present when analysing the results for BMI was 72% ( p < 0.01), which decreased to 0% ( p = 0.57) when analysing the outcomes for weight, in which case the null hypothesis of homogeneity could be accepted. In all instances, the final summary of the effect was on the decreasing side for both BMI and BW; (4) Conclusions: Despite the high heterogeneity of the results reported, the trend shown in all cases indicates that the intervention methodologies implemented by empowering individuals through Web 2.0 technologies are positive in terms of the problem of overweight. Further implementation of novel strategies to support individuals is needed to overcome obesity, and, at least in the early studies, these strategies seem to be making the necessary change.

Background: Data analysis techniques such as machine learning have been used for assisting in triage and the diagnosis of health problems. Nevertheless, it has not been used yet to assist community pharmacists with services such as the Minor Ailment Services These services have been implemented to reduce the burden of primary care consultations in general medical practitioners (GPs) and to allow a better utilization of community pharmacists' skills. However, there is a need to refer high-risk patients to GPs. Aim: To develop a predictive model for high-risk patients that need referral assisting community pharmacists' triage through a minor ailment service. Method: An ongoing pragmatic type 3 effectiveness-implementation hybrid study was undertaken at a national level in Spanish community pharmacies since October 2020. Pharmacists recruited patients presenting with minor ailments and followed them 10 days after the consultation. The main outcome measured was appropriate medical referral (in accordance with previously co-designed protocols). Nine machine learning models were tested (three statistical, three black box and three tree models) to assist pharmacists in the detection of high-risk individuals in need of referral. Results: Over 14'000 patients were included in the study. Most patients were female (68.1%). With no previous treatment for the specific minor ailment (68.0%) presented. A percentage of patients had referral criteria (13.8%) however, not all of these patients were referred by the pharmacist to the GP (8.5%). The pharmacists were using their clinical expertise not to refer these patients. The primary prediction model was the radial support vector machine (RSVM) with an accuracy of 0.934 (CI95 = [0.926,0.942]), Cohen's kappa of 0.630, recall equal to 0.975 and an area under the curve of 0.897. Twenty variables (out of 61 evaluated) were included in the model. radial support vector machine could predict 95.2% of the true negatives and 74.8% of the true positives. When evaluating the performance for the 25 patient's profiles most frequent in the study, the model was considered appropriate for 56% of them. Conclusion: A RSVM model was obtained to assist in the differentiation of patients that can be managed in community pharmacy from those who are at risk and should be evaluated by GPs. This tool potentially increases patients' safety by increasing pharmacists' ability to differentiate minor ailments from other medical conditions., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Amador-Fernández, Benrimoj, García-Cárdenas, Gastelurrutia, Graham, Palomo-Llinares, Sánchez-Tormo, Baixauli Fernández, Pérez Hoyos, Plaza Zamora, Colomer Molina, Fuertes González, García Agudo and Martínez-Martínez.)

Children with Unilateral Spastic Cerebral Palsy (US CP) have motor and somatosensory impairments that affect one side of their body, impacting upper limb functioning. These impairments contribute negatively to children's bimanual performance and quality of life. Intensive home-based therapies have been developed and have demonstrated their feasibility for children with US CP and their parents, especially when therapies are designed with the proper coaching of families. Mirror Therapy (MT) is being studied to become an approachable intensive and home-based therapy suitable for children with US CP. The aim of this study is to analyze the feasibility of a five-week home-based program of MT for children with US CP that includes coaching by the therapist. Six children aged 8-12 years old performed the therapy for five days per week, 30 min per day. A minimum of 80% of compliance was required. The feasibility included compliance evaluations, total dosage, perceived difficulty of the exercises, and losses of follow-ups. All children completed the therapy and were included in the analysis. The total accomplishment was 86.47 ± 7.67. The perceived difficulty of the exercises ranged from 2.37 to 4.51 out of 10. In conclusion, a home-based program of Mirror Therapy is a safe, cost-efficient, and feasible therapy for children with US CP when the therapist is involved as a coach during the entire program.

In this retrospective analysis of children with atopic dermatitis (n = 6) who coincidentally had a video polysomnography, we found that most nocturnal limb movements in children with atopic dermatitis are non-scratch versus scratch, 109.0 ± 67.9 vs. 15.3 ± 5.4 (p = 0.01). Average scratch duration was 8.4 ± 2.7 s, which was not different by sleep stage. Scratch movements are distinct in timing, occurring most often during N2 sleep, in the first third of sleep, and peaking at 90 minutes after sleep onset, corresponding with completion of the first sleep cycle., (© 2022 The Authors. Pediatric Dermatology published by Wiley Periodicals LLC.)

Giving birth is one of the most impressive experiences in life. However, many pregnant women suffer from fear of childbirth (FOC) and experience labour in very different ways, depending on their personality, previous life experiences, pregnancy, and birth circumstances. The aim of this study was to analyse how fear of childbirth affects the childbirth experience and to assess the related consequences. For this, a descriptive cross-sectional study was carried out in a sample of 414 women between 1 July 2021 and 30 June 2022. The Birth Anticipation Scale (BAS) was used to measure fear of childbirth and the Childbirth Experience Questionnaire (CEQ-E) was applied to measure satisfaction with the childbirth experience. Fear of childbirth negatively and significantly predicted the childbirth experience. In addition, women who were more fearful of childbirth were found to have worse obstetric outcomes and a higher likelihood of having a caesarean delivery ( p = 0.008 C. I 95%). Fear behaved as a risk factor for the birth experience, so the greater the fear, the higher the risk of having a worse birth experience (OR 1.1). Encouraging active listening and support strategies may increase pregnant women's confidence, thus decreasing their fear of the process and improving their childbirth experience.

Background: The emotional state of parents of babies with Down syndrome affects their babies' development and their parent-child bonding. The aim for this study was to conduct a pilot randomised controlled evaluation of the effect of infant massage on parents of babies with Down syndrome., Methods: This pilot study compared two groups (intervention and control), each with 16 parents of babies with Down syndrome. Indices of acceptance, engagement and awareness of influence were measured at two different time points (pre-test and after 5 weeks) using the 'This Is My Baby' Interview. The allocation of families to each group was randomised. The experimental group performed infant massage, applied by the parents, for 5 weeks, every day for at least 10 min. The massage protocol was based on the methodology created by Vimala McClure. Parents in the control group received the intervention after completion of the study., Results: The indices of acceptance, commitment and awareness of influence improved in the experimental group and in the control group. The 2 × 2 mixed-model analysis of variance indicates a statistically significant group-by-time interaction for all indices (P < 0.001), which was significantly higher in the experimental group than in the control group., Conclusions: The application of infant massage, by parents to their babies, improves the rates of acceptance, commitment and awareness of influence of parents of babies with Down syndrome in the short term., (© 2022 The Authors. Journal of Intellectual Disability Research published by MENCAP and International Association of the Scientific Study of Intellectual and Developmental Disabilities and John Wiley & Sons Ltd.)

Objective: To examine the feasibility of a home-based hybrid Bimanual-Intensive-Therapy combined with modified Constraint-Induced-Movement-Therapy (h-BITmCI) in children with spastic unilateral cerebral palsy (SUCP) with low and very low bimanual functional level., Methods: A single-group of 10 children aged 5-8 years old, performed the hybrid home Bimanual-Intensive-Therapy (BIT, 80 hours) combined with modified Constraint-Induced-Movement-Therapy (mCIMT, 20 hours): h-BITmCI. Thus, Bimanual Functional Performance (BFP), Quality of Life (QoL) and expectations from families were measured through the Assisting Hand Assessment, (AHA), Pediatric Quality of Life Inventory, for Cerebral Palsy, (PedsQL TM v. 3.0, CP) and a specific questionnaire for families for baseline period (week 0), during the treatment phase (week 4 and week 8) and after the intervention (week 10). Repeated measures ANOVA analysis (with post hoc test correction) was used for the BFP and QoL, with a confidence interval (CI) of 95% and with p value <.008 considered statistically significant., Results: Ten children completed the study with an average of 77-hours-BIT and 17-hours-mCIMT. None of the participants dropped out of the study during the follow-up process, and the parents' expectations were fulfilled, indicating high caregiver compliance. During the first 80 hours of BIT, a mean increase of 3.7 AHA units was obtained for the BFP (p = 1.00) and 1.64 points in the QoL (p = 1.00). Clinically relevant changes were observed in the last two weeks (20 hours mCIMT) with a mean increase of 10.6 AHA units in BFP and 6.29 points in QoL (p < .001)., Conclusions: h-BITmCI protocol is feasible to be performed at home with the family's involvement, obtaining the greatest improvements after 100 hours of both therapies. Thus, mCIMT would be a relevant condition to increase the affected upper limb functionality, rather than the dosage used to obtain clinically relevant changes.

The participation of adolescents with cerebral palsy (CP) within the community is reduced compared to their peers and is a barrier to their socialization, self-determination and quality of life. Patient and Public Involvement (PPI) is a key strategy for successful interventions, especially when involvement of the stakeholders takes place at all stages of the research. Co-design can be crucial for success as researchers, patients with CP and their families work together to bring the necessary elements to the interventions to be designed. The objectives will be: (1) To co-design an intervention aimed at improving the participation of adolescents with significant motor disabilities within the community in partnership with adolescents with CP, families and rehabilitation professionals. (2) To assess the feasibility of the co-design process in partnership with interested parties. The study will be based on Participatory Action Research (PAR) and will be held in Spain and Brazil. In both countries, the study will be carried out remotely with nine adolescents aged 12 to 17 years with CP, Gross Motor Function Classification System (GMFCS) levels IV-V, their families and six health professionals (physiotherapists and occupational therapists). Different dialogue groups will be created to involve adolescents, families and health professionals to the research's project. To manage their involvement in the co-design process, the Involvement Matrix (IM) will be used, and according to the IM phases, four steps will be included in the research: (1) Preparation; (2) Co-design; (3) Analysis: results of the intervention protocol and the study's feasibility and (4) Dissemination of results. Partnering with the public to design an intervention to improve participation can bring better results compared to protocols designed only by health professionals. In addition, it will allow for knowing the needs of adolescents with CP in terms of participation within the community. The study will also explore which roles were chosen by all participants and how they felt while actively participating in the process of co-designing an intervention protocol and their own perspectives on the use of the involvement matrix.

Background: Developmental coordination disorder (DCD) is a developmental disorder in which numerous comorbidities seem to coexist, such as motor and visual impairment and some executive functions; Methods: A narrative review on motor and visual deficits in children with DCD was carried out; Results and Discussion: Fine and gross motor skills are affected in children with DCD. In addition, they seem to be related to visual deficits, such as difficulty in visual perception, sensory processing and visual memory. Limitations have also been found in accommodation. Interventions in children with DCD should be aimed at improving both aspects, since vision affects motor skills and vice versa; Conclusions: In children with DCD, who present a marked deficit in global shape processing, it causes an association between deficiencies in visual perception and motor skills., Competing Interests: The authors declare no conflict of interest.

Introduction: Unilateral spastic cerebral palsy affects upper extremity function. Mirror and home-based action observation therapies may be useful in its treatment. The aim has been to evaluate the feasibility of action observation therapy and mirror therapy programmes combined with home action observation in children with unilateral spastic cerebral palsy., Subjects and Methods: The feasibility study included children (6-12 years old), randomly assigned to two groups: action observation therapy and mirror therapy and action observation. Twenty-hour home sessions were conducted, including unimanual and bimanual activities. Feasibility of interventions and procedures, and spontaneous use (Assisting Hand Assessment scale) and functionality (Jebsen Taylor Hand Function Test) of the upper extremity were assessed., Results: Twenty-five families were recruited, with 17 meeting the inclusion criteria. Twelve children (8.75 ± 2.38 years) participated in the study. All families completed the interventions, with no adverse effects. The total intervention dose was above 96%. After the intervention, clinically relevant changes were found in both groups in spontaneous use of the upper extremity, as well as in functionality in the action observation therapy group., Conclusions: Action observation therapy and mirror therapy combined with action observation therapy are considered feasible to be applied at home and aimed at children with unilateral spastic cerebral palsy.

Increased life expectancy in Spain has highlighted the need for formal caregivers who care for older adults who live at home. In many cases, families choose to hire immigrants from Latin America who, on many occasions, have been forced to emigrate, which causes a considerable psychological impact on them. To this, other factors such as precarious working conditions, loneliness, or high workload are added, which leads to many caregivers becoming sick. The aim of this study was to assess the quality of life and the level of anxiety derived from the workload of Latin American immigrants who come to Spain to care for older adults. A descriptive cross-sectional study was carried out using two validated questionnaires to measure this relationship. A correlation was also established between quality of life and anxiety as expressed by the participants. The sample consisted of a total of 426 subjects. One of the main results showed that the lower the caregiver's quality of life, the higher their level of anxiety (OR = 1.06; 95% CI). Live-in caregivers had a lower quality of life than people who did not live in the same house as the cared-for person (OR = 2.22; 95% CI). Working long hours and having a high workload was associated with poorer quality of life and higher levels of anxiety. Assessing immigrants who are formal caregivers and providing them with the support that helps to improve their quality of life is suggested to reduce the occurrence of anxiety disorders.

Background: It is crucial to start an early intervention in unilateral cerebral palsy. Intensive therapies are focused on training based on activities., Objective: The objective of the study was to study the changes in the bimanual functional performance (BFP) after early intensive therapies at home compared with standard care in children with unilateral cerebral palsy from 9 to 18 months of age., Design: A single-blind comparative effectiveness study will be conducted., Methods and Analysis: Children will be randomized into four groups: infant-mCIMT, infant-BIT, infant-hybrid, and infant standard therapy (control group, CG). Each early intensive protocol will last 50 h and will be applied throughout a 10-week period with the family involvement at home. The main outcomes are BFP measure with mini-Assisting Hand Assessment (mini-AHA) scale, functional goals measure with Goal Attainment Scale (GAS), and satisfaction and expectations on intensive therapy from parents measure through specific questionnaire. Baseline characteristics between groups will be compared using independent t test and Fisher's exact test. Pre- and post-treatment outcomes of standard assessments will be compared using analysis of variance (ANOVA) for parametric and Kruskal-Wallis test for non-parametric variables. The Bonferroni correction is applied for multiple comparisons. An alpha level of p  ⩽ 0.05 is considered significant., Discussion: In relation to other studies that have analyzed intensive therapies, although with fewer intervention groups, it seems that the application of any of the intensive interventions is effective with the applied dose to obtain changes in BFP and increase the spontaneous use of the affected upper limb., Registration: ClinicalTrials.gov Identifier: NCT04642872., Competing Interests: The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article., (© The Author(s), 2022.)

Purpose: The aim of this study was to review the available scientific literature on the possible relationship between the visual system and motor development in children., Methods: This study was performed according to the Preferred Reporting Items for Systematic Reviews (PRISMA) statement recommendations. The review protocol is available in PROSPERO (CRD42021245341). Four different databases, namely Scopus, PubMed, CINAHL and Web of Science, were assessed from April 2005 to February 2021. To determine the quality of the articles, we used the Critical Appraisal Skills Programme (CASP) Quality Appraisal Scale, and a protocol was followed to define the levels of evidence on the basis of the Centre for Evidence-Based Medicine Levels of Evidence. The search strategy included terms describing motor development in children and adolescents with visual disorders., Results: Among the identified studies, 23 were included in the study. All selected articles examined the relationship between the visual system and development in children. The quality of most of the studies was moderate-high, and they were between evidence levels 2 and 4., Conclusions: Our systematic review revealed that all included studies established a relationship between the visual system and development in children. However, the methods for measuring the visual system and motor skills lacked uniformity., (© 2022 The Authors. Acta Ophthalmologica published by John Wiley & Sons Ltd on behalf of Acta Ophthalmologica Scandinavica Foundation.)

Background: Entrepreneurial intention is considered to be the best predictor of entrepreneurial behaviour. The Theory of Planned Behaviour (TPB) explains the degree of correlation between variables such as entrepreneurial intention, perceived feasibility and perceived desirability. Knowing the entrepreneurial intention of students of Health Sciences will help to guide and promote effective university policies to support entrepreneurship. The authors aimed to analyse the entrepreneurial intention of university students in the field of Health Sciences., Methods: A cross-sectional study was conducted in the Faculties of Health Sciences of two public universities of Southern Spain. 1518 students of different degrees of Health Sciences (Physiotherapy, Podiatry, Dentistry, Nursing and Occupational Therapy), from first to fourth year. An online structured questionnaire was used, the Entrepreneurial Event Model (EEM) adapted to the Spanish context. This measurement model was completed with 8 items from the Motivated Strategies for Learning Questionnaire-MSLQ., Results: The hypothetical model showed that perceived desirability and perceived feasibility were positive and significant predictors of entrepreneurial intention. Perceived desirability showed an indirect effect on entrepreneurial intention through perceived feasibility. Expectation of success and self-efficacy had no direct effect on entrepreneurial intention., Conclusions: Perceived desirability and perceived feasibility are related to entrepreneurial intention in Health Sciences students., (© 2022. The Author(s).)

Objective: To evaluate the effectiveness of transcranial direct current stimulation (tDCS) combined with exercising in people with fibromyalgia., Design: Randomized, triple-blind, sham-controlled, clinical trial., Setting: Primary health care center., Participants: A total of 120 volunteer participants (N=120) between 18 and 65 years old and diagnosed with fibromyalgia. Four participants dropped out of the study for causes unrelated to the intervention., Intervention: Participants were randomized into 3 groups (active tDCS+exercising, sham tDCS+exercising, no-intervention control). The intervention was delivered in 5 sessions over 2 weeks., Main Outcome Measures: Pain intensity and referred pain area after suprathreshold pressure stimulation., Results: Pain intensity further decreased in the active tDCS group vs control (mean, -14.43; 95% confidence interval, -25.27 to -3.58) at post intervention, unlike the sham tDCS group. Both tDCS groups did not achieve greater reductions in referred pain vs control. In the active tDCS group, health status (mean, -14.80; 95% confidence interval, -23.10 to -6.50) and pain catastrophizing (mean, -6.68, 95% confidence interval, -11.62 to -1.73) improved at post intervention, and so did health status (mean, -8.81; 95% confidence interval, -17.11 to -0.51), pain catastrophizing (mean, -7.00; 95% confidence interval, -12.13 to -1.87), and depression (mean, -3.52; 95% confidence interval, -6.86 to -0.19) after 1 month. In the sham tDCS group, improvements were recorded in health status (mean, -13.21; 95% confidence interval, -21.52 to -4.91) and depression (mean, -3.35; 95% confidence interval, -6.35 to -0.35) at post intervention and in health status (mean, -8.77; 95% confidence interval, -17.06 to -0.47), pain catastrophizing (mean, -5.68; 95% confidence interval, -10.80 to -0.55), and depression (mean, -3.98; 95% confidence interval, -7.31 to -0.64) after 1 month. No intergroup differences were observed between active and sham tDCS., Conclusions: Active and sham tDCS improved health status, pain catastrophizing, and depression vs control, but pain intensity decreased only in the active tDCS group., (Copyright © 2022 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.)

According to the Social Motivation model children with autism show deficits in social orienting (looking at faces and responding to name) at the end of their first year of life. In this model, those deficits are both the earliest behavioral consequences of an alteration in the dopamine reward system balance and the foundation of the social impairments that characterize this neurodevelopmental disorder. The current study tests two of the main predictions of this model: that social orienting deficits are the first behavioral manifestation of autism, and that they are developmentally related to joint attention deficits. We retrospectively analyzed family home movies of 9- to 12-month-old infants, 29 of whom were later diagnosed with autism and 16 of whom were typically developing. After confirming that the videotapes of both groups were similar in content of the scenes recorded (contexts, type of social activity, etc.), we compared their social orienting (social gaze and responding to name) and joint attention behaviors (gaze alternation and gestures). No significant differences between groups were found in looking at faces, but the group with autism showed deficits in responding to name and initiations of joint attention (IJA). Looking at people was not significantly correlated with IJA behaviors, but response to name was. The lack of group differences in looking at faces between 9 and 12 months, and the existence of IJA difficulties in the ASD group without concurrent impairment in looking at faces, do not support predictions of the Social Motivation model. LAY SUMMARY: Various theories have been proposed to explain the emergence of autism symptoms early in life. This study tested two key predictions of the Social Motivation model. Comparing family movies of children 9- to 12-months-old later diagnosed with autism or with typical development, we did not observe difficulties in looking at other people's faces but children with autism responded to name and used gaze and gestures to direct the adult's attention to events of interest less frequently. This absence of difficulties in looking at faces does not fit with what the Social Motivation model of autism predicts and therefore we must develop alternative explanations., (© 2022 International Society for Autism Research and Wiley Periodicals LLC.)

Background and Objectives : Pregnancy and postpartum are periods that imply numerous physical and psychological changes that could lead to mental health consequences. The aim of the present study is to identify whether women who had body image dissatisfaction had a higher incidence of postpartum depression 6 months after birth than women who did not have body image dissatisfaction. Materials and Methods : A descriptive cross-sectional study was designed with a sample of 450 women from two hospitals in Andalusia. Quantitative variables were age and scores on the Edinburgh Postnatal Depression Scale (EPDS) and the Body Shape Questionnaire (BSQ) for body image dissatisfaction. The qualitative variables used were marital status, self-perceived health status, diet or physical exercise, type of delivery, and others. Results : Body dissatisfaction was positively correlated with the symptomatology of postpartum depression. Thus, for each point increased in body dissatisfaction, the occurrence of depression also increased. There was a relationship between the study variables, so women who were more dissatisfied with their body image were more frequently depressed. Conclusions : In conclusion, it can be established that postpartum depression seems to be related to the presence of poor body image.