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Resumen Introduccion Los trastornos neurologicos son una causa frecuente de discapacidad infantil. Las disfunciones neuromotrices se afrontan clinicamente en la actualidad mediante tratamientos ortopedicos, farmacologicos y fisioterapicos. Las vibraciones terapeuticas son estudiadas para conocer sus efectos troficos y neuromoduladores. Objetivo Observar los cambios relacionados con el control postural en casos de disfuncion neuromotriz infantil despues de la aplicacion de estimulos vibratorios ecologicos, medidos con una plataforma de fuerzas. Pacientes y metodos Estudio consecutivo no controlado. Quince sujetos con discapacidad motora y edad media 9 ± 3,4 anos fueron valorados en bipedestacion estatica mediante la plataforma Wii Balance Board antes y despues de una unica dosis de amplificacion mecanoceptiva (AM). Se analizaron variables del centro de presiones: posicion media, excursion media, amplitud y recorrido. Resultados La posicion media conjunta del centro de presiones pre-AM se encontraba mas alejada del centro anatomico en el eje frontal que en el sagital de manera estadisticamente significativa (p = 0,041) y mostraron recorridos mediolaterales del centro de presiones significativamente mas largos (p = 0,001) que los anteroposteriores. Post-AM hubo aumentos significativos para la variables excursion media total (p = 0,015), amplitud en eje frontal (p = 0,010), y recorrido tanto en el total (p = 0,005) como en los parciales de ambos ejes frontal (p = 0,006) y sagital (p = 0,004). A la observacion, la posicion sagital media conjunta se retraso mientras que la posicion frontal media conjunta se aproximo hacia el centro, con elevada correlacion entre reubicacion y excursion y entre amplitud y recorrido. Conclusion Los sujetos obtuvieron un reequilibrio postural tendente hacia la posteriorizacion y hacia el miembro inferior estimulado despues de la AM.

This systematic review aimed to provide an up-to-date analysis of the effects of equine-assisted therapies (EAT) in people with multiple sclerosis (PwMS). The Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA) guidelines were followed to conduct this systematic review. PubMed and Web of Science databases were employed in the search, which ended in February 2022. The risk of bias analysis was performed using the Evidence Project tool. After removing duplicates, thirty-nine studies were identified. However, only ten fulfilled the inclusion criteria and were included in this systematic review. Therefore, a total of 195 PwMS, aged between 40.3 and 51.3, were included in this systematic review. EAT-based interventions had a mean length of 13.6 weeks with a session´s frequency ranging from ten to once a week. All sessions involved real horses and lasted a mean of 34.4 min. Among the included articles, four were randomized controlled trials (RCT), four did not perform randomization, and two employed a prepost design without a control group. RCTs showed positive effects on quality of life, fatigue, balance, spasticity, and gait speed. Furthermore, non-RCT showed improvements in balance, spasticity, and postural control (postural control was not assessed in RCT studies). Importantly, significant effects were only observed when the comparison group was inactive or followed usual care. Therefore, EAT is a promising and effective therapy to improve quality of life, fatigue, balance, spasticity, and gait speed in PwMS. However, since comparison groups are heterogeneous, results could vary depending on the research design. Moreover, the inclusion of noncontrolled studies (in order to have a wide perspective of the state of art) could increase the risk of bias and make the results be taken with caution.

BACKGROUND: One of the main problems faced by physiotherapists in primary care is low back pain with or without radiation to lower limbs. There are many different treatment approaches for the management of low back pain. Despite the large amount of published studies, the evidence remains contradictory. OBJECTIVE: To evaluate the influence of the osteopathic manipulation of the sacroiliac joint on low back pain with or without radiation to lower limbs. METHOD: Single-blind randomized clinical controlled trial. Participants with low back pain with or without lower limb radiation were randomized to osteopathic manipulation of the sacroiliac joint group (intervention, 6 sessions) or to an electrotherapy group (control, 15 sessions) for 3 weeks. Measures were taken at baseline (week 0) and post-intervention (week 4). The primary outcome measures were pain (Visual Analogue Scale), functional disability (Oswestry disability index and Roland Morris questionnaire). The secondary outcome measure was pain threshold at muscular tender points in the quadratus lumborum, pyramidal, mayor gluteus, and hamstrings. RESULTS: In all, 37 participants completed the study. The results of the intragroup comparisons showed statistically significant improvements in both groups in the visual analogue scale (Osteopathic manipulation group, P= 0.000; Electrotherapy group, P= 0.005) and Oswestry disability index (Osteopathic manipulation group, P= 0.000; Electrotherapy group- P= 0.026) but not in the Roland Morris questionnaire (P= 0.121), which only improved in the intervention group (P= 0.01). The osteopathic manipulation was much more effective than electrotherapy improving to pain and functional disability. CONCLUSION: Osteopathic manipulation of the sacroiliac joint improves pain and disability in patients with sacroiliac dysfunction after three weeks of treatment.

Resumen Introduccion La causa mas prevalente de discapacidad infantil es la paralisis cerebral. Se ha demostrado que la terapia vibratoria tiene efectos beneficiosos sobre el control postural, siendo una de las limitaciones en la paralisis cerebral infantil. Su valoracion nos permite asi orientar las intervenciones terapeuticas. El objetivo de este estudio fue determinar la eficacia terapeutica de las microvibraciones funcionales sobre la estabilidad y los apoyos en bipedestacion. Material y metodo Aplicacion durante 3 meses, a un nino de 6 anos con tetraparesia distonica, de un protocolo de intervencion mediante un dispositivo Mecanoamplificador un dia a la semana mientras caminaba 15 min. Se realizo una valoracion postural pre- y postintervencion mediante una plataforma de fuerzas portatil Wii Balance Board. Resultados Se observaron modificaciones en indicadores de estabilidad postural que sugieren mejoras inmediatas y acumuladas. Conclusion La amplificacion mecanoceptiva podria incorporarse como una terapia eficaz sobre el control postural deficitario en la paralisis cerebral.

Cerebral palsy (CP) treatment includes physical therapy and various complementary therapies to the standard clinical treatment. However, there are not many reviews that focus on the methods used and evaluation procedures. This study aims to analyze which tools are most suitable for the evaluation and methodology of patients with CP treated with physical therapy. Following the PRISMA statement, through a PICOS strategy, PubMed/MEDLINE, Web of Science (WOS), Scopus, Science Direct, and Scielo were searched with the following terms: cerebral palsy AND (physical therapy modalities OR therapeutics) AND outcome assessment. The methodological quality of the RCTs was assessed with the Evidence Project risk of bias tool. Thirty-seven RCTs and six RCT protocols, comprising 1359 participants with different types of CP: spastic hemiplegia/paresis, spastic diplegia/paresis, and spastic CP, met the inclusion criteria, uncovering 21 variables measured through 77 different instruments and several interventions. The therapies most widely used in CP are gaming or technology-assisted therapies, aerobic training, hippotherapy, music therapy, gait training, and aquatic exercises. This study provides an overview of what the authors used in the neurorehabilitation field through procedure evaluation and checking the technological advance that began to be used.

Resumen Introduccion La reeducacion postural global (RPG) implica una serie de movimientos con la participacion activa del paciente y se basa en la idea integral del sistema muscular. Debido a la relacion del complejo articular con diferentes estructuras se plantea un abordaje de tratamiento con este metodo. Objetivo Evaluar los resultados de un tratamiento con el metodo RPG en lesiones localizadas a nivel del complejo articular del hombro. Metodologia Veinte sujetos fueron divididos en 2 grupos: grupo 1 con sujetos sanos y grupo 2 con pacientes con enfermedad de hombro. Se realizaron 2 valoraciones (pre y postratamiento) y 3 sesiones semanales de 30 min. En cada sesion se realizaron 3 posturas. Resultados En el grupo 1 se observo una mejora significativa (p 0,05). En el grupo 2 se obtuvo un aumento de la movilidad del complejo articular del hombro y de movilidad a nivel del raquis dorsal y lumbar, asi como una disminucion del dolor. Conclusiones El metodo RPG podria ser util para el tratamiento de lesiones localizadas a nivel del complejo articular del hombro, siendo una terapia valida para introducirse dentro del programa de intervencion terapeutico en sujetos susceptibles a tratamiento fisioterapico en lesiones de dicho complejo articular y como terapia de prevencion y mantenimiento de sujetos sanos.

Resumen Introduccion Las luxaciones recidivantes de hombro estan muy presentes en la poblacion actual. La accion quirurgica de eleccion se divide entre la intervencion de Bankart o de Latarjet. Objetivo Describir pautas terapeuticas fisioterapicas de tratamiento en la luxacion recidivante de hombro intervenida con la tecnica de Latarjet. Material y metodo Estudio de caso de un paciente, varon de 38 anos, intervenido mediante tecnica de Latarjet tras luxacion anterior recidivante de hombro, al que se le aplica fisioterapia antialgica, terapia manual y reeducacion muscular. Resultados El paciente experimento mejoria en el balance articular (rotacion externa 90°/rotacion interna 70°) y muscular (5+ en la escala Lovett-Daniels), asi como una disminucion del dolor (0 en escala EVA) y una mejora en la respuesta miedo/evitacion al movimiento. Conclusion Tras el periodo de recuperacion el paciente lleva una evolucion favorable, tanto en la actuacion rehabilitadora desarrollada como en la estabilidad glenohumeral propuesta por intervencion.

Background: The joint position sense (JPS) has been used as an indirect marker of proprioception in subjects with non-specific chronic low back pain (NSCLBP), showing impairment in previous studies. It seems necessary to devise reliable tests to measure proprioceptive deficits in subjects with NSLBP. The objective of this study was to analyse the test–retest reliability and smallest real difference (SRD) of lumbar proprioception through the JPS indicator in a sample of patients with NSCLBP. Methods: Fifty participants with NSCLBP performed three repetitions of 30° lumbar flexion while standing and sitting using the iPhone® inclinometer application to measure the lumbar joint repositioning error. For the reliability analysis, we performed an intra-session test–retest. Results: The total sample ICC values were excellent for standing (0.96) and sitting (0.93) 30° lumbar flexion. In addition, our results showed that, for the total sample, an SRD &lt, 12% can be considered as a true change in proprioception concerning this procedure. On the other hand, men have better reliability than women in both standing and sitting positions. Additionally, the sitting position has better reliability than the standing position. The standard error of measurement (SEM) percentage was 4.2 for standing and 3.8 for sitting. The SRD percentage was 11.6 for standing and 10.4 for sitting. Conclusions: The iPhone® inclinometer seems reliable for assessing proprioceptive ability through the lumbar joint repositioning error in subjects with NSCLBP in both standing (ICC = 0.96) and sitting (ICC = 0.93) positions. This technological device showed a lower measurement error for sitting position (SRD &lt, 12%).

Background Nonspecific chronic low back pain (NSCLBP) is one of the most common and frequent health problems. Objetive to compare postural control (i.e. center of pressure (CoP) displacement and energy spectral density (ESD)) using technological devices (accelerometers and pressure platform) between subjects with NSCLBP and healthy subjects. Methods A cross-sectional case-control study was conducted. Observational study (STROBE). The final sample consisted of 60 subjects (30 NSCLBP subjects and 30 healthy subjects). Triaxial accelerometer and pressure platform were used in order to obtain ESD and CoP displacement measurements during four balance tasks (i.e. with and without vision and on stable versus unstable surface). Independent t tests were used to compare participants with NSCLBP and healthy controls in the two clinical measurements (i.e., CoP displacement and ESD) for the four balance tests. A multivariate analysis of variance (MANOVA) together with a Fisher's linear discrimination was applied in order to categorize NSPLBP. Results Patients with NSCLBP showed greater CoP migration in the positions eyes open, stable surface on the anteroposterior axis (p = 0.012), eyes closed, stable surface on the mediolateral axis (p = 0.025), eyes closed, stable surface on the anteroposterior axis (p = 0.001), eyes open, unstable surface on the anteroposterior axis (p = 0.040), eyes closed, unstable surface on the anteroposterior axis (p = 0.015). Also the ESD was significantly greater for the four situations described (p ≤ 0.01) in subjects with NSCLBP. Conclusions Accelerometer appears to be a technological device that could offer a potential benefit within the battery of tests on physical performance among subjects with NSCLBP and healthy subjects.

Resumen Introduccion La valoracion funcional del paciente es un elemento relevante en la practica clinica prestando atencion a la desadaptacion al ejercicio como consecuencia del proceso patologico. El grado de desadaptacion podemos valorarlo mediante pruebas de campo, como las pruebas ISWT y 6 MWT. La acelerometria puede ser una herramienta de utilidad para valorar la actividad fisica y el consumo energetico. El objetivo de este estudio es determinar el gasto energetico entre las pruebas de valoracion funcional ISWT y 6 MWT; analizar las diferencias y el grado de correlacion existente entre ellas, teniendo en cuenta el nivel de actividad fisica de los sujetos. Metodos Veintiseis sujetos jovenes sanos realizaron las pruebas ISWT y 6 MWT con la colocacion de un acelerometro triaxial en la muneca que registraba el movimiento. Resultados Las pruebas ISWT y 6 MWT mostraron un consumo distinto para todos los sujetos (p Conclusion La acelerometria es util para la medicion del gasto energetico en pruebas submaximas de valoracion funcional, permitiendonos asi relacionar el consumo energetico con el nivel de actividad fisica.

The objectives of this study are to determine the displacement of the center of pressure (CoP) and its association with the spectral energy density of the acceleration required for the maintenance of postural balance in different standing positions in healthy participants using design observational and setting laboratorial studies. Participants were 30 healthy university students aged between 18 and 32 years old (mean [M] ± standard deviation [SD] = 21,57 ± 3,31 years). Triaxial accelerometer and a pressure platform were used in order to obtain energy spectral density and CoP sway measurements during four balance tasks. Statistically significant differences were found for anteroposterior (p = 0.002) and mediolateral (p = 0.009) CoP displacement between the conditions eyes closed and stable surface and the conditions eyes closed and unstable surface. A statistically significant correlation was also observed between Z-axis (anterior-posterior) of the accelerometer and mediolateral axis of the CoP (r = 0.465; p = 0.01) and between Y-axis accelerometer (mediolateral) and displacement of the CoP in the anteroposterior axis (r = 0.413; p = 0.023). Spectral energy density appears to be associated with the displacement of CoP in healthy participants.

Resumen Introduccion La valoracion del control postural y el equilibrio es de relevancia para orientar las intervenciones terapeuticas, al ser los aspectos mas afectados que limitan a las personas con alteraciones en la marcha, las postura, y las actividades de la vida diaria. Se ha demostrado que la acelerometria es de utilidad para la valoracion del equilibrio postural. Objetivos Determinar, en un estudio preliminar en sujetos sanos, indicadores basados en la acelerometria eficaces para valorar la sedestacion y la bipedestacion en situaciones de estabilidad e inestabilidad, con y sin control visual. Metodologia Se valoro a 26 sujetos sanos mediante la colocacion de acelerometros triaxiales y realizando diferentes pruebas en sedestacion y bipedestacion. Resultados La energia necesaria para la busqueda del equilibrio ante situaciones de inestabilidad se vieron en una banda de frecuencias de 1,5-3 Hz. Conclusiones Los indicadores para valorar el control postural y el equilibrio que podrian ser de utilidad para los terapeutas son: root mean square, densidad espectral de la energia y espectro de frecuencias.

Resumen Antecedentes y objetivos La falta de control postural es a menudo el factor limitante para participar en actividades de la vida diaria, identificandose como la mayor limitacion para el desarrollo motor de los ninos con paralisis cerebral. Es por ello de especial importancia la valoracion del control postural y del equilibrio en la paralisis cerebral, para la orientacion del tratamiento en la practica clinica. El objetivo de este estudio es mostrar la evolucion de la estabilidad postural en una nina con paralisis cerebral que recibe hipoterapia. Descripcion del caso Se presenta el caso de una nina de 8 anos con hemiparesia derecha como resultado de una paralisis cerebral. Intervencion Se han realizado 14 sesiones de hipoterapia llevadas a cabo una vez por semana y con duracion de 45 min cada sesion. La valoracion de la estabilidad postural se ha analizado con una plataforma de presion, realizando 2 tipos de medicion: estatica y posturologica, con ojos abiertos y cerrados. Resultados Tras la intervencion, existen modificaciones positivas en la distribucion de la huella plantar, la ubicacion del centro de gravedad y la estabilidad postural en sentido antero-posterior, siendo el eje medio-lateral el que ha manifestado menos variabilidad de mejora. Ademas, los mejores porcentajes de cambio se han producido con los ojos cerrados. Discusion La literatura nos muestra que se produce una mejoria significativa de la estabilidad postural despues de haber llevado a cabo un tratamiento de hipoterapia. Realizando una valoracion exhaustiva y con la utilizacion de una plataforma barometrica podemos observar las modificaciones producidas por la intervencion terapeutica.