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[Aims] This study aimed to quantify the degrees of movement that occur in the lower limb using a kinematic system after taking two measurements of 45° and 60° of extension at the first metatarsophalangeal joint (1st MTPJ) and to test the validity of this sensor system using radiography., [Methodology] This was a quasi-experimental test-post-test study with a single intervention group (25 subjects). Four inertial sensors were placed on the proximal phalange of the first toe, dorsum of the foot, medial-lateral of the leg (level of tibia), and medial-lateral of the thigh (level of femur). The extension of the 1st MTPJ produced movements of supination in the foot and rotation at the level of leg and thigh. We studied this mechanism in three situations (relaxed, 45°, and 60°) both with the sensors and with X-rays., [Results] With the kinematic system, there was an increase in the range of movement in each of the variables, with a value of p < 0.05. The relationship between the kinematic system and the radiography was tested using Spearman’s rho test, obtaining a correlation coefficient of 0.624 and a value of p < 0.05, and the Bland–Altman graph, with 90% of the cases within the tolerance limits., [Conclusions] The extension of the 1st MTPJ generated kinematic changes associated with supination movement in the midfoot and external rotation on the tibia and femur level. Both measurement techniques were very similar in the way that they quantified the degrees of extension of the 1st MTPJ. If we extrapolate this result to the measurement technique used by the inertial sensors, we could affirm that the values recorded in the supination and external rotation movements were reliable.

[Objective] This study aimed to assess the immediate and short-term effects of cervical spinal manipulation (SM), compared with a placebo, on the magnitude of near and distance exophoria in adults with asymptomatic exophoria., [Methods] In this single-blind, randomized controlled trial, individuals with a clinical diagnosis of horizontal exophoria confirmed with the prism alternating cover test (PACT) were allocated to a single intervention session using a high-velocity, low-amplitude cervical SM technique or a sham intervention (manual contact under the head). Outcomes were the magnitude of horizontal heterophoria, as a measure of binocular vision efficiency at near (40 cm) or distance (4 m) fixation, using the PACT. Evaluations were made at baseline, immediately after intervention, and at a 1-week follow-up., [Results] From May to September 2021, 44 volunteers (23 women), with a mean age of 35 (SD = 9.5) years, were recruited and equally distributed into the study groups. All participants completed follow-up assessments, and no adverse events were reported. There was a significant time × group interaction for exophoria at near vision, but not at distance fixation. The SM group showed a significant decrease of near exophoria compared with the control group at the 1-week follow-up (mean difference = −1.09 prism diopters; 95% CI = −0.20 to −1.98 prism diopters)., [Conclusion] The use of cervical SM therapy resulted in a significant reduction of the magnitude of horizontal exophoria at near vision (medium effect size), compared with the placebo, in young adults who are asymptomatic. However, these effects were not observed at distance fixation and should be considered cautiously due to the pre–post design with a single intervention session and the short-term follow-up., [Impact] The findings suggest short-term benefits of SM therapy can manage undiagnosed ocular convergence disorders, although changes were not clinically relevant.

[Background]: Plantar fasciitis is a painful disorder that affects the plantar fascia of the foot, with a multifactorial aetiology. Dorsal flexion deficiency in the ankle is a risk factor for it. The provisional use of taping is described as part of conservative treatment. Dynamic Tape® is a type of tape that, adhered to muscles, allows for potential elastic energy to accumulate and dissipate later, optimizing its function. Therefore, it can offer immediate benefits while the patient awaits definitive treatment depending on the cause., [Objective]: To verify the effectiveness of Dynamic Tape® and the low-dye taping technique on pain intensity, ankle range of motion, and foot posture index., [Method]: A randomised, double-blind clinical trial was conducted. A total of 57 subjects from the Clinical Podiatry Area of the University of Seville (Spain), clinically diagnosed with plantar fasciitis, were randomized into two groups. For one week, in the gastrocnemius–Achilles–plantar system, one group was treated with Dynamic Tape® and another group with low-dye taping. Pain, degrees of movement of dorsal flexion, and the foot posture index were measured in both groups before the intervention and one week after the intervention. A repeated-measures analysis of variance (ANOVA) was used to explore the differences between groups., [Results]: Significant differences in the decrease in pain intensity using Dynamic Tape® were found when comparing the treatments (p = 0.015) and the foot posture index was more normal in low-dye taping (p < 0.001). In both cases, the treatment showed similar behaviour with respect to the dorsal flexion ankle movement., [Conclusion]: The effectiveness of Dynamic Tape®, compared to that of the low-dye taping, has a major benefit with regard to pain intensity from fasciitis, although it does not produce changes in the ankle range of motion and foot posture index. Consequently, Dynamic Tape® can be considered a taping technique with beneficial effects on pain intensity in the provisional approach to plantar fasciitis.

Objective: The aims that we set in this study were to analyse the kinematic and kinetic changes in the lower limbs of cyclists when using the utility model, nº of publication ES 1078023, which consists of a system of cleats with an exact omnidirectional adjustment and without oscillations between the shoe and the pedal. Methods: This is a quasi-experimental, longitudinal and prospective study with a non-randomized sampling. The sample was made up of 34 cyclists. The variables studies focused on the kinematics of each joint of the lower limb in three planes and the kinetics in the function of the angular position of the cleat. They had the Bioval® system put in place, through which the kinematic parameters were recorded at the points marked on the lower limb for 20 s. Three systems were used for the kinetics (Power Tap, Rotor and Pioneer), recording the power developed for 1 min for each of the study situations. Results: Regarding the kinematic variables, statistically significant differences were found for the three planes in all of the structures studied. As for the kinetics, statistically significant differences were also observed, both when analyzing them globally and when doing so for each of the systems. Conclusions: The variation in the rotational position of the cleat influences both the cyclist’s kinematics and dynamics.

Objective: This study aimed to assess the immediate and short-term effects of cervical spinal manipulation, compared with a placebo, on the magnitude of near and distance exophoria in adults with asymptomatic exophoria. Methods: In this single-blind, randomized controlled trial, individuals with a clinical diagnosis of horizontal exophoria confirmed with the prism alternating cover test (PACT) were allocated to a single intervention session using a high-velocity, low-amplitude cervical spinal manipulation technique or a sham intervention (manual contact under the head). Outcomes were the magnitude of horizontal heterophoria, as a measure of binocular vision efficiency at near (40 cm) or distance (4 m) fixation, using the PACT. Evaluations were made at baseline, immediately after intervention, and at a 1-week follow-up. Results: From May to September 2021, 44 volunteers (23 women), with a mean age of 35 (SD = 9.5) years, were recruited and equally distributed into the study groups. All participants completed follow-up assessments, and no adverse events were reported. There was a significant time x group interaction for exophoria at near vision, but not at distance fixation. The spinal manipulation group showed a significant decrease of near exophoria compared to the control group at the 1-week follow-up (mean difference = -1.09 prism diopters; 95% CI = -0.20 to - 1.98 prism diopters). Conclusion: The use of cervical spinal manipulation therapy resulted in a significant reduction of the magnitude of horizontal exophoria at near vision (medium effect size), compared with the placebo, in young adults who are asymptomatic. However, these effects were not observed at distance fixation and should be considered cautiously due to the pre-post design with a single intervention session and the short-term follow-up. Impact: The findings suggest short-term benefits of spinal manipulation therapy can manage undiagnosed ocular convergence disorders, although changes were not clini

Objective: The present study aimed to assess the immediate and short-term effect of cervical spinal manipulation (SM), compared with placebo, on the magnitude of near and distance exophoria, in adults with asymptomatic exophoria. Methods: In this single-blinded randomized controlled trial, individuals with a clinical diagnosis of horizontal exophoria, as confirmed with the prism alternating cover test (PACT), were allocated to a single intervention session using a high-velocity low-amplitude cervical SM technique or sham placebo (manual contact under the head). The study outcome was the magnitude of horizontal heterophoria, as a measure of binocular vision efficiency, at near (40 cm) or distance (4 meters) fixation, using the PACT. Evaluations were made at baseline, immediately after intervention, and at a 1-week follow-up. Results: From May to September 2021, forty-four volunteers (23 females), with a mean age of 35 (9.5) years, were recruited and equally distributed into the study groups. All participants completed follow-up assessments, and no adverse events were reported. There was a significant time*group interaction for exophoria at near vision but not at distance fixation. The SM group showed a significant decrease of near exophoria, compared to the control group, at the 1-week follow-up (mean difference -1.09 prism diopters, 95% CI, -0.20 to -1.98 prism diopters). Conclusion: The use of cervical SM therapy resulted in a significant reduction of the magnitude of horizontal exophoria at near vision (medium effect size), compared with placebo, in asymptomatic young adults. However, these effects were not observed at distance fixation and should be considered with caution due to the pre-post design with a single intervention session and the short-term follow-up. Impact: The present findings suggest short-term benefits of SM therapy to manage undiagnosed ocular convergence disorders, although changes were not clinically relevant.

Background Patients with diabetes mellitus are exposed to important complications. Currently little evidence exist on the guidelines that these patients, at some risk of foot ulceration, should follow for physical exercise. Objectives To reach a consensus among multidisciplinary and international experts on physical activity/exercise recommendations for patients with diabetes, according to foot ulcer risk. Methods Using a three-round Delphi method, a panel composed of 28 multidisciplinary experts in the management of diabetic foot assessed 109 recommendations on physical activity/exercise for patients with diabetes mellitus, according to their risk of foot ulcer. Consensus was assumed when 80% of responses matched the same category (agreement/disagreement). Results Twenty-nine experts participated in the first and second rounds of consultation, and twenty-eight did so in the third, reaching final agreement on 86 of the 109 recommendations considered (78.9%). The study, thus, generated a consensus set of recommendations concerning different aspects of diabetic footcare before, during, and after exercise (e.g. when to examine the foot, how to assess it, what type of sock and insole to use, what types of exercise to perform, and when it is advisable to return to activity after an ulceration). Conclusion This Delphi study generated recommendations based on the consensus of international experts on physical activity and exercise by patient with diabetes at risk of ulceration. Recommendations considered the state of the foot and the patient's history and status before physical activity and included information on intensity, duration, frequency, and progressions of physical activity/exercise, and the use of custom-made plantar orthoses, shoe prescription, and the convenience of returning to physical activity after an ulceration.

Objective: The aims that we set in this study were to analyse the kinematic and kinetic changes in the lower limbs of cyclists when using the utility model, nº of publication ES 1078023, which consists of a system of cleats with an exact omnidirectional adjustment and without oscillations between the shoe and the pedal. Methods: This is a quasi-experimental, longitudinal and prospective study with a non-randomized sampling. The sample was made up of 34 cyclists. The variables studies focused on the kinematics of each joint of the lower limb in three planes and the kinetics in the function of the angular position of the cleat. They had the Bioval® system put in place, through which the kinematic parameters were recorded at the points marked on the lower limb for 20 s. Three systems were used for the kinetics (Power Tap, Rotor and Pioneer), recording the power developed for 1 min for each of the study situations. Results: Regarding the kinematic variables, statistically significant differences were found for the three planes in all of the structures studied. As for the kinetics, statistically significant differences were also observed, both when analyzing them globally and when doing so for each of the systems. Conclusions: The variation in the rotational position of the cleat influences both the cyclist’s kinematics and dynamics.

Background: Plantar fasciitis is a painful disorder that affects the plantar fascia of the foot, with a multifactorial aetiology. Dorsal flexion deficiency in the ankle is a risk factor for it. The provisional use of taping is described as part of conservative treatment. Dynamic Tape® is a type of tape that, adhered to muscles, allows for potential elastic energy to accumulate and dissipate later, optimizing its function. Therefore, it can offer immediate benefits while the patient awaits definitive treatment depending on the cause. Objective: To verify the effectiveness of Dynamic Tape® and the low-dye taping technique on pain intensity, ankle range of motion, and foot posture index. Method: A randomised, double-blind clinical trial was conducted. A total of 57 subjects from the Clinical Podiatry Area of the University of Seville (Spain), clinically diagnosed with plantar fasciitis, were randomized into two groups. For one week, in the gastrocnemius–Achilles–plantar system, one group was treated with Dynamic Tape® and another group with low-dye taping. Pain, degrees of movement of dorsal flexion, and the foot posture index were measured in both groups before the intervention and one week after the intervention. A repeated-measures analysis of variance (ANOVA) was used to explore the differences between groups. Results: Significant differences in the decrease in pain intensity using Dynamic Tape® were found when comparing the treatments (p = 0.015) and the foot posture index was more normal in low-dye taping (p < 0.001). In both cases, the treatment showed similar behaviour with respect to the dorsal flexion ankle movement. Conclusion: The effectiveness of Dynamic Tape®, compared to that of the low-dye taping, has a major benefit with regard to pain intensity from fasciitis, although it does not produce changes in the ankle range of motion and foot posture index. Consequently, Dynamic Tape® can be considered a taping technique with beneficial effects on pain intensi

Background: Dizziness and imbalance are common and disabling symptoms in patients with multiple sclerosis (MS) and are caused by a central, peripheral, or mixed vestibulopathy. Central vestibular disorder is the most frequently reported vestibular problem in the MS population due to demyelination. Vestibular rehabilitation ameliorates these symptoms and their repercussions and improves quality of life. Immersive virtual reality (VRi) is an emerging tool in this field; however, no previous research has been performed studying its effects in MS. Objective: The aim of this study was to apply a VRi vestibular training protocol to a patient with MS and assess the effects induced by the experimental intervention. Methods: This case study included a 54-year-old woman with relapsing-remitting MS. We developed a standardized VRi exercise protocol for vestibular rehabilitation based on the gold-standard Cawthorne-Cooksey vestibular training protocol. The 20-session intervention was made up of 10 initial sessions and 10 advanced sessions. Each 50-minute session was performed two to three times per week for 7 weeks. Four evaluations were carried out over the study period: at baseline (T0), between initial and advances phases (T1), postintervention (T2), and 1 month after the experimental procedure (T3). The research outcomes were dizziness, balance, gait, impact of fatigue, quality of life, repercussions in muscular tone, and usability of the head-mounted display device. Results: After implementing the VRi vestibular protocol, improvements were seen in the following patient parameters: Dizziness Handicap Inventory score (62 points at T0; 4 points at T2); Berg Balance Scale score (47 points at T0; 54 points at T2); instrumented Timed Up and Go time (8.35 seconds at T0; 5.57 seconds at T2); muscular tone of the erector spinae, rectus femoris, and soleus; Modified Fatigue Impact Scale score (61 points at T0; 37 points at T2); and Multiple Sclerosis Quality of Life-54 values (67.16

OBJETIVO: Este estudio se plantea con el objetivo de valorar, en una población de deportistas jóvenes y asintomáticos, la posible relación entre la mecanosensibilidad neural de la maniobra de valoración slump y las lesiones deportivas del miembro inferior. MATERIAL Y METODO: Se realizó el test de slump, en ambas piernas, a una población de 110 futbolistas sanos y asintomáticos pertenecientes a categorías juvenil y cadete de la escuela de futbol de Rayo Alcobendas. Se registró la respuesta al slump como positiva o negativa y se anotaron las lesiones ocurridas durante la temporada. RESULTADOS: Los resultados obtenidos mostraron 80 sujetos de los cuales 42 test fueron positivos (17 con lesión y 25 sin lesión) y 38 negativos (17 con lesión y 21 sin). Hubo un total de 51 jugadores con lesión (45,7%) y 59 sin lesión (54,3%). CONCLUSIONES: Los resultados del análisis estadístico sugirieron que no hay diferencias significativas entre los jugadores que han sufrido lesiones y los que no han tenido lesiones en el test de slump positivo o negativo (bilateral, unilateral, derecho, izquierdo, totales derechos, totales izquierdos).

Excessive foot pronation has been reported as being related to chronic low back pain symptoms and risk factors in sports-specific pathologies. Compensating custom-made foot orthotics treatment has not been entirely explored as an effective therapy for chronic low back pain (CLBP). This study aims to observe the effects of custom-made foot orthoses, in subjects with foot pronation suffering from CLBP. A total of 101 patients with nonspecific CLBP and a pronated foot posture index (FPI) were studied. They were randomized in two groups: an experimental one (n = 53) used custom-made foot orthotics, and the control group (n = 48) were treated with non-biomechanical effect orthoses. The CLBP was measured using the Oswestry Disability Index (ODI) Questionnaire and a visual analogue scale (VAS), both for lower back pain. The symptoms were evaluated twice, at first when the subject was included in the study, and later, after 4 weeks of treatment. The analysis of outcomes showed a significant decrease in CLBP in the custom-made foot orthoses participants group (p < 0.001 ODI; p < 0.001 VAS). These findings suggest that controlling excessive foot pronation by using custom-made foot orthoses may significantly contribute to improving CLBP.

The incidence of falls in adults constitutes a public health problem, and the alteration in balance is the most important factor. It is necessary to evaluate this through objective tools in order to quantify alterations and prevent falls. This study aims to determine the existence of alteration of balance and the influence of age in a population of healthy women. Static posturography was performed on 49 healthy adult women with no history of falls in four different situations using the Romberg test with the NedSVE/IBV® platform. The variables studied were the body sway area and the anteroposterior and mediolateral displacements. The situation of maximum instability occurred in RGC (p = 0.001), with a significant increase in anteroposterior oscillations regarding the ML (p < 0.001), with no correlation to age. Age alone does not influence the balance in the sample studied, other factors must come together to alter it. The joint cancellation of visual and somatosensory afferents could facilitate the appearance of falls, given that it is a situation of maximum instability. Proprioceptive training is interesting as a preventive strategy for falls.

Running shoes typically have a lifespan of 300–1000 km, and the plantar pressure pattern during running may change as the shoe wears. So, the aim of this study was to determine the variation of plantar pressures with shoe wear, and the runner’s subjective sensation. Maximun Plantar Pressures (MMP) were measured from 33 male recreational runners at three times during a training season (beginning, 350 km, and 700 km) using the Biofoot/IBV® in-shoe system (Biofoot/IBV®, Valencia, Spain). All the runners wore the same shoes (New Balance® 738, Boston, MA, USA) during this period, and performed similar training. The zones supporting most pressure at all three study times were the medial (inner) column of the foot and the forefoot. There was a significant increase in pressure on the midfoot over the course of the training season (from 387.8 to 590 kPa, p = 0.003). The runners who felt the worst cushioning under the midfoot were those who had the highest peak pressures in that area (p = 0.002). The New Balance® 738 running shoe effectively maintains the plantar pressure pattern after 700 km of use under all the zones studied except the midfoot, probably due to material fatigue or deficits of the specific cushioning systems in that area.

La cervicalgia mecánica la padecen del 45% al 70% de la población general durante algún periodo de sus vidas y es una de las causas más frecuentes de baja laboral. Dada su importancia a nivel clínico en fisioterapia en este estudio pretendemos observar la influencia de una técnica de movilización de la escápula sobre la mecanosensibilidad neural del mediano medido con Upper Limb Neural Test 1 (ULNT1) en sujetos con cervicalgia mecánica. Hipótesis y objetivos. La aplicación de la una técnica de movilización de la escapula a sujetos que presentan una cervicalgia mecánica y un ULNT1 positivo, mejora la respuesta del paciente a dicho test, a la vez que disminuye el dolor cervical del paciente medido con una Escala Analógica Visual (EVA) del dolor e incrementa la fuerza prensil. Material y método. Se realizó un ensayo clínico a simple ciego con asignación aleatoria de los sujetos en dos grupos intervención y control. La muestra estuvo compuesta por 60 individuos (N = 60), 30 para el grupo intervención (n = 30) y otros 30 para control (n = 30) y estuvo formada por pacientes con cervicalgia mecánica y un ULNT1 positivo. A los primeros se les realizó una movilización de la escápula y a los segundos una movilización en abducción aducción del calcáneo del lado contrario al test de ULNT1 positivo a modo de placebo. Resultados. Tras la aplicación de la movilización de la escápula en el grupo intervención observamos una mejora significativa en la mecanosensibilidad neural del mediano (ULNT1) (p-valor<0,001), así como en la fuerza medida con dinamómetro de presión manual antes y después de la intervención (pvalor= 0,037) y en el dolor medido con EVA antes y después de la intervención (p-valor<0,001). Conclusiones. La aplicación de la una técnica de movilización de la escapula en sujetos que presentan una cervicalgia mecánica y un ULNT1 positivo, mejora significativamente la mecanosensibilidad neural del mediano, la fuerza prensil y el dolor (EVA)., Between 45% and 70% of the general population suffers neck pain at some point in their lives, making it one of the most frequent reasons for taking sick leave. Given its importance in physiotherapy at clinical level, we seek to observe how a scapular mobilization technique might influence the neural mechanosensitivity of the median nerve as measured by Upper Limb Neural Test 1 (ULNT1) on subjects with neck pain. Hypotheses and objectives. Performing a scapular mobilization technique on subjects with neck pain and a positive ULNT1 improves the patient's response to said test. It also decreases the patient's neck pain as measured using a Visual Analog Scale (VAS) for pain and increases grip strength. Material and method. A single-blind clinical trial was performed on subjects randomly assigned to either a treatment group or control group. The sample consisted of 60 subjects (N = 60) –30 in the treatment group (n = 30) and the other 30 as a control (n = 30) –and was made up of patients with neck pain and a positive ULNT1. A scapular mobilization was performed on the first group and on the second, a calcaneus abduction adduction on the opposite side from the positive ULNT1 as a placebo. Results. After performing the scapular mobilization on the treatment group, significant improvement was observed in neural mechanosensitivity of the median nerve (ULNT1) (p-value <0.001), as was the strength measured using a manual pressure gauge pre- and post-treatment (p-value = 0.037) and pain levels measured using a VAS pre- and post-treatment (p-value <0.001). Conclusions. Performing a scapular mobilization technique on subjects with neck pain and a positive ULNT1 significantly improves the neural mechanosensitivity of the median nervve, grip strength and pain (VAS).

El propósito de este estudio es determinar si la técnica de manipulación suboccipital Occipucio-atlas-axis (OAA) tiene efecto sobre la movilidad ocular en individuos con heteroforia, es decir, desviación ocular no manifiesta. Sobre una muestra de 59 individuos que presentaban esta disfunción de movilidad ocular se evaluó de forma objetiva con el Cover test alterno y la prueba de Thorington modificada. Posteriormente, a los individuos que formaron parte del grupo experimental se les realizó la técnica de manipulación OAA, y a los que formaron parte del grupo control una maniobra placebo. Se realizaron a partir de este momento dos mediciones más, una inmediatamente después de la ejecución de la técnica y otra una semana después. Los resultados muestran una disminución próxima a la significatividad estadística (p=0,09) en la medición una semana después de la intervención, no siendo así en la medición inmediatamente después de la ejecución de la técnica. Este estudio nos permite afirmar que la técnica de manipulación suboccipital OAA constituye una herramienta eficaz en el tratamiento de la heteroforia.