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Objective: To assess differences in neural mechanosensitivity between patients with chronic nonspecific neck pain with and without neuropathic features (NF and No-NF, respectively). Design: Descriptive, cross-sectional study. Setting: A primary care center, a hospital physiotherapy outpatient department, and a university campus. Subjects: Chronic nonspecific neck pain patients classified by the self-completed leeds assessment of neuropathic symptoms and signs pain scale (S-LANSS; 49 patients with NF [S-LANSS ≥ 12] and 50 patients with No-NF [S-LANSS < 12]) and a healthy control group (n = 48). Methods: The primary measurements were the mechanosensitivity of the median nerve and cervical region, specifically the assessment of the onset of symptoms and submaximal pain intensity according to the upper limb neural test 1 (ULNT1) for the median nerve and the modified passive neck flexion test (MPNFT) for the cervical region; secondary measurements included pain intensity, neck disability, kinesiophobia, and pain catastrophizing. Results: Statistically significant differences between the NF and No-NF groups were found with respect to the onset of symptoms of ULNT1 (-15.11 [-23.19 to -7.03]) and MPNFT (-6.58 [-11.54 to -1.62]), as well as the outcomes of the visual analogue scale (Mean difference [95% Confidence Interval]; 7.12 [1.81-12.42]) and neck disability index (3.72 [1.72-5.71]). Both chronic nonspecific neck pain groups showed statistically significant differences compared with the control group for all outcomes assessed (P < 0.01) except for the onset of symptoms of ULNT1 in the No-NF group. Conclusions: The findings of this study suggest that chronic nonspecific neck pain patients with NF have greater neural mechanosensitivity, pain intensity, and neck disability than those with No-NF., Sección Deptal. de Radiología, Rehabilitación y Fisioterapia (Enfermería), Fac. de Enfermería, Fisioterapia y Podología, TRUE, pub

Objective: The aim of this study was to determine the effectiveness of a multimodal treatment in the short and medium term for disability in nonspecific chronic neck pain. Design: The design of this study is a single-blinded randomized controlled trial carried out in a university research laboratory. Forty-five patients between 18 and 65 yrs with nonspecific chronic neck pain were included in this study. Each patient was treated eight times over a 4-wk period. The sample was divided into three groups: control group, subjected to a protocol of manual therapy; experimental group 1, subjected to a protocol of manual therapy and therapeutic patient education; and experimental group 2, subjected to manual therapy, therapeutic patient education, and a therapeutic exercise protocol. Assessments were performed at baseline and at 4, 8, and 16 wks using the following measurements: the Neck Disability Index, the 11-item Tampa Scale of Kinesiophobia, the Fear Avoidance Beliefs Questionnaire, the Neck Flexor Muscle Endurance Test, and the Visual Analog Fatigue Scale. Results: The nonparametric Kruskal-Wallis test for the Neck Disability Index showed statistically significant differences between baseline outcomes and all follow-up periods (P < 0.01). In the Kruskal-Wallis test, differences were found for the Visual Analog Fatigue Scale and the Neck Flexor Muscle Endurance Test in the follow-ups at 8 and 16 wks (P < 0.05). Analysis of variance for group × time interaction showed statistically significant changes (Tampa Scale of Kinesiophobia, F = 3.613, P = 0.005; Fear Avoidance Beliefs Questionnaire, F = 2.803, P = 0.022). Minimal detectable changes were obtained in both experimental groups for the 11-item Tampa Scale of Kinesiophobia but not in the control group. Conclusion: Differences between experimental groups and the control group were found in the short and medium term. A multimodal treatment is a good method for reducing disability in patients with nonspecific chronic nec, Sección Deptal. de Radiología, Rehabilitación y Fisioterapia (Enfermería), Fac. de Enfermería, Fisioterapia y Podología, TRUE, pub

Objective: Insufficient evidence exists to compare widespread pain (WP), pain sensibility, and psychological factors that occur in patients presenting with chronic neck pain (CNP) or a combination of temporomandibular disorder (TMD) and other complaints. The present study compared the pain sensibility and psychological factors of subjects with CNP with those with TMD + CNP. Design: Cross-sectional study. Setting: Local community. Subjects: A nonprobabilistic convenience sample of 86 persons with CNP or TMD was recruited into three groups: CNP, TMD with myofascial pain in masticatory muscles with cocomitant CNP (TMD + CNP), and asymptomatic control groups consisted of 27, 29, and 30 participants, respectively. Methods: Participants underwent a clinical examination to evaluate WP with computerized assessment based on the pain drawing, pressure pain thresholds (PPT), and psychological factors, which were evaluated using the pain catastrophizing scale (PCS) and the state-trait anxiety inventory (STAI). Results: Statistically significant differences were observed between participants with CNP and TMD + CNP for WP (t = -2.80, P < 0.01, d = -1.06). Post hoc analyses only revealed significant differences between TMD + CNP participants and asymptomatic controls for PPT at extratrigeminal areas. Pearson correlation analyses showed a moderate positive association between symptomatic groups within the WP and STAI ( P < 0.05) and a moderate negative association between PCS and PPT ( P < 0.05) at the right tibialis muscle. Conclusion: TMD + CNP participants had more areas of pain and also showed widespread pain hyperalgesia. Both groups of participants had psychological factors positively associated with STAI and WP; further, PCS and the PPT at the extratrigeminal region were negatively associated with each other in both groups, except for the left tibialis in the TMD + CNP group., Sección Deptal. de Radiología, Rehabilitación y Fisioterapia (Enfermería), Fac. de Enfermería, Fisioterapia y Podología, TRUE, pub

Introduction: The aim of the present study is to analyze the correlation between people that suffer from chronic ankle instability and muscle strength deficits of the proximal joints of the lower limb, which are the hip and knee. Methods: The narrative review was conducted on MEDLINE using the selected keywords to build the search string. After inclusion and exclusion criteria were applied, the articles were independently screened by two authors reading the titles and abstracts or full articles. The quality assessment was conducted using the NIH quality assessment tool for observational cohort and cross-sectional studies, the methodological index for non-randomized studies scale, the risk-of-bias tool for non-randomized trials, and the Critical Appraisal Skills Programme checklist. Result: From 506 papers originally identified through database search, six studies were finally selected. The quality score was medium to low in all studies according to selected tool. Major of the included studies underlined that the lower limb strength deficits represent a key factor in the rehabilitation path in patients with chronic ankle instability (CAI) and, in addition to predictable ankle’s muscle impairments, hip strength was a significant weakness in performance evaluation in this type of patients. Conclusion: It’s not possible to confirm to our knowledge a strictly significant correlation between strength deficit of hip and knee, when appreciated. These results, however, might suggest another time that the difference between people who suffer from CAI and coper is the rehabilitation program that patients follow after an injury., Introducción: El objetivo del presente estudio es analizar la correlación entre personas que padecen inestabilidad crónica del tobillo y déficits de fuerza muscular de las articulaciones proximales del miembro inferior, que son la cadera y la rodilla. Métodos: La revisión narrativa se realizó en MEDLINE utilizando las palabras clave seleccionadas para construir la cadena de búsqueda. Después de aplicar los criterios de inclusión y exclusión, dos autores examinaron los artículos de forma independiente y leyeron los títulos y resúmenes o los artículos completos. La evaluación de la calidad se realizó utilizando la herramienta de evaluación de la calidad de los NIH para estudios observacionales de cohortes y transversales, el índice metodológico para la escala de estudios no aleatorios, la herramienta de riesgo de sesgo para ensayos no aleatorios y la Critical Appraisal Skills. Lista de verificación del programa. Resultado: De 506 artículos identificados originalmente mediante búsqueda en bases de datos, finalmente se seleccionaron seis estudios. La puntuación de calidad fue de media a baja en todos los estudios según la herramienta seleccionada. La mayoría de los estudios incluidos subrayaron que los déficits de fuerza de las extremidades inferiores representan un factor clave en el camino de rehabilitación en pacientes con inestabilidad crónica del tobillo (ICA) y, además de las deficiencias musculares predecibles del tobillo, la fuerza de la cadera fue una debilidad significativa en la evaluación del rendimiento. en este tipo de pacientes. Conclusión: No es posible confirmar, hasta donde sabemos, una correlación estrictamente significativa entre el déficit de fuerza de la cadera y la rodilla, cuando se aprecia. Estos resultados, sin embargo, podrían sugerir en otra ocasión que la diferencia entre las personas que sufren CAI y las que padecen coper es el programa de rehabilitación que siguen los pacientes después de una lesión.

Background Temporomandibular disorders (TMDs) are the most common cause of orofacial pain of non‑dental origin, with approximately 42% of diagnoses corresponding to myofascial pain. Manual therapy and dry needling are commonly used interventions for the treatment of myofascial temporomandibular disorders. However, it is unclear whether one of them could be superior to the other. Objectives The aim of the present systematic review and network meta‑analysis was to compare the effectiveness of manual therapy and dry needling in patients with myofascial TMD. Methods This is a systematic review and network meta‑analysis. Randomized clinical trials were searched in the data‑ bases of Pubmed, PEDro, CINAHL, Web of Science, Scopus, Cochrane, Google Academic and EMBASE. The methodo‑ logical quality of studies included in this review was judged using the Physiotherapy Evidence Database (PEDro) scale. A frequentist network meta‑analysis was carried out, assuming random effects, to estimate the effects of interventions for temporomandibular joint pain measured on a 10‑point visual analogue scale. Results Out of 3190 records identified, 17 met the inclusion criteria for qualitative analysis and eight were included in the network meta‑analysis. Indirect comparisons between dry needling and manual therapy showed no significant differences in their effects on pain reduction (Odds Ratio [95%CI]; − 0.263 [− 1.517, 0.992]). The ranking of treatments shows that manual therapy (SUCRA = 0.932) followed by deep dry needling (SUCRA = 0.775) present the highest val‑ ues of estimation and can be considered the most likely to reduce pain. Conclusions The results of the network meta‑analysis should be considered with caution due to the low quality of the evidence available and the high variability of the study protocols in terms of the method of application of dry needling and manual therapy interventions. PROSPERO under identifier: (CRD42020186470).

[Abstract] Shoulder antepulsion, altered scapular kinematics and imbalance of muscle activity are commonly associated with shoulder pain. This study aimed to observe if there is an association between the forward shoulder angle (FSA) and the pectoralis minor length index (PMI) in volleyball players with and without shoulder pain. Furthermore, this study observed if there is an association between shoulder posture and upper limb mechanical hyperalgesia in volleyball players with and without shoulder pain. Methods: a cross-sectional study was conducted in the Physiotherapy and Pain Research Center in Alcalá de Henares (Spain). A total of 56 volleyball players met the inclusion criteria and agreed to enter the study. Subjects were divided into two groups: shoulder pain group (SPG) and control group (without pain). The following measurements of the dominant sides of the players were collected: FSA, PMI, and pressure pain threshold (PPT) in serratus anterior, lower trapezius, infraspinatus, teres minor, upper trapezius, levator scapulae, pectoralis major, radial nerve, cubital nerve, and median nerve. Results: The Spearman’s Rho revealed no significant correlations were found between FSA and PMI. Moreover, Spearman’s Rho test revealed in the SPG a negative moderate correlation between FSA and Infraspinatus-PPT (Rho = −0.43; p = 0.02); FSA and levator scapulae-PPT (Rho = −0.55; p < 0.01); FSA and pectoralis major-PPT (Rho = −0.41; p = 0.02); PMI and cubital nerve-PPT (Rho = −0.44; p = 0.01). Conclusions: No association was found between the forward shoulder angle and the pectoralis minor index in volleyball players with and without shoulder pain. There is a moderate negative association between shoulder forward angle and muscle mechanical hyperalgesia in volleyball players with shoulder pain, but no such associations were found in volleyball players without shoulder pain. Treatment of the infraspinatus, levator scapulae, pectoralis major, and pectoralis minor muscles coul

Purpose: Background: Evaluate whether the design of placebo control groups could produce different interpretations of the efficacy of manual therapy techniques. Methods: Nine databases were searched (EMBASE, CINAHL, PsycINFO, MEDLINE, PubMed, SCOPUS, WEB of SCIENCE, COCHRANE, and PEDro). Randomized placebo-controlled clinical trials that used manual therapy as a sham treatment on subjects suffering from pain were included. Data were summarized qualitatively, and meta-analyses were conducted with R. Results: 53 articles were included in the qualitative analysis and 48 were included in the quantitative analyses. Manipulation techniques did not show higher effectiveness when compared with all types of sham groups that were analyzed (SMD 0.28; 95%CI [−0.24; 0.80]) (SMD 0.28; 95%CI [−0.08; 0.64]) (SMD 0.42; 95%CI [0.16; 0.67]) (SMD 0.82; 95%CI [−0.57; 2.21]), raising doubts on their therapeutic effect. Factors such as expectations of treatment were not consistently evaluated, and analysis could help clarify the effect of different sham groups. As for soft tissue techniques, the results are stronger in favor of these techniques when compared to sham control groups (SMD 0.40; 95%CI [0.19, 0.61]). Regarding mobilization techniques and neural gliding techniques, not enough studies were found for conclusions to be made. Conclusions: The literature presents a lack of a unified placebo control group design for each technique and an absence of assessment of expectations. These two issues might account for the unclear results obtained in the analysis.