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The International Consultation on Incontinence Questionnaire-Pediatric Lower Urinary Tract Symptoms (ICIQ-CLUTS) is a 12-item self-administered tool to screen lower urinary tract symptoms (LUTS) in children. The aim of this study is to translate and validate the ICIQ-CLUTS into Spanish (ICIQ-CLUTS-Sp) and to study its psychometric properties. The cross-cultural adaptation of the ICIQ-CLUTS was performed following international recommendations. The psychometric analysis of the ICIQ-CLUTS-Sp was carried out to determine the reliability, validity, and diagnostic accuracy in a sample of 155 children and parents who completed the Spanish version ICIQ-CLUTS. The reliability indicators for the ICIQ-CLUTS-Sp were excellent (Cronbach’s alpha was > 0.8 and ICC > 0.9 both for children’s and parents’ versions). There was a high Pearson r > 0.6 and a high agreement level between children’s and parents’ answers (ICC > 0.6), except in 4 items. For parents, the standard error of measurement (SEm) was 0.41, and the minimal detectable change (MDC) was 1.14 points. In children, these results were 0.42 and 1.16 points, respectively. Cut-off points greater than 15 points in the parent version or 16 points in the children version have the highest sensitivity and specificity for detecting LUTS. Conclusion: The Spanish version of the ICIQ-CLUTS questionnaire is a valid, reliable, and diagnostically accurate instrument to identify cases of children with LUTS. Therefore, it can be used to screen for lower urinary tract symptoms in Spanish speaking children and/or parents, as well as to monitor the effects of interventions. What is Known: • Lower urinary tract symptoms in children should be assessed multimodally using minimally invasive diagnostic procedures. One way to do this is to use the questionnaire to differentiate these cases in paediatric patients. • A cross-cultural adaptation of the ICIQ-CLUTS questionnaire to Spanish has not yet been done. What is New: • Based on a comprehensive validation methodology, this study highlights that the ICIQ-CLUTSSp questionnaire has good psychometric properties.

Martin-San Agustin, R, Benitez-Martinez, JC, Medina-Mirapeix, F, and Casana-Granell, J. Sex differences and patterns of muscle stiffness in the knee flexor and extensor musculature through analysis of isolated bellies. J Strength Cond Res 35(4): 1044-1049, 2021-Muscle stiffness (MS) is one of the key factors in joint control. The purpose of this study was to determine sex differences in the MS of 5 isolated muscle bellies (biceps femoris [BF], semitendinosus [ST], rectus femoris [RF], vastus medialis [VM], and vastus lateralis [VL]) and in the pattern of differences among their respective MS. Twenty female and 20 male recreational athletes participated. Muscle stiffness was measured by tensiomyography using maximum radial deformation (Dm) as an indirect indicator of MS. Sex differences were observed only in the Dm of RF (mean difference = 2.07 mm, p < 0.05) when values were adjusted by body mass and stature. Males and females showed a similar pattern in the Dm between the muscle bellies: within the hamstrings, ST had a significantly higher Dm than BF in females (3.02 mm) and males (4.28 mm); within the quadriceps, RF also had a significantly higher value than VL and VM in females (6.50 and 7.38 mm, respectively) and males (4.87 and 4.82 mm, respectively). Sex differences in patterns were found between BF and the vastus muscles: the BF of females had a significantly higher Dm than VL (3.78 mm) and VM (4.51 mm), but this was not observed in males. Differences may imply different involvement of the bellies in countering the movements of the lower extremities. Our results can help to direct exercises to improve the MS in certain muscular bellies.

Background There are still many barriers when implementing exercise routines within daily dialysis care, even though benefits are well-known. Developing cost-effective strategies is necessary to overcome these barriers and include exercise as a complementary therapy in dialysis. Aim To compare several exercise programs on hemodialysis patient's functional capacity and health-related quality of life. Design This study was a 16-week follow-up, two-parallel group trial with balanced randomization. Setting Participants in this study belonged to a private hospitalized care center. Population Referred sample of 71 patients that suffered end-stage chronic kidney disease who underwent hemodialysis for at least 3 months and had a medical stable condition. Methods 36 participants performed during 16 weeks an intradialytic exercise program lead by the nursing staff of the hemodialysis unit and 35 a home-based program supervised by physical therapists of the hospital. Results The main researcher and the data analyst were both blinded to participant allocation. There was a significant effect in time for both groups. Participants improved significantly in the Short Performance Physical Battery (SPPB), One-Leg Heel-Rise (OLHR) and 6 Minute-Walk Test (6MWT), and in the Physical Activity Scale for the Elderly (PASE) and Short Survey Form 36 (SF-36) questionnaires. Conclusions Nurse-led and home-based exercise interventions produce beneficial effects involving physical function, activity levels and health-related quality of life in patients undergoing hemodialysis. Clinical rehabilitation impact The study emphasizes the importance of exercise rehabilitation routines in fragile populations such as dialysis patients, and the potential to overcome barriers for its daily implementation.

Context: The prevalence and negative consequences of the symptoms surrounding patellar tendinopathy constitute an important problem for sports medicine professionals. The identification of potential pain mediators is, therefore, of major interest to improve both the prevention and management of this injury. Objective: To compare the pain experienced by elite male adult basketball players and patterns of patellar tendon abnormalities. Also, to identify whether structural and vascular sonographic abnormalities (focal area of hypoechogenicity, thickening, and neovascularization [NV]) are equal in determining pain perceptions. Design: An observational study with professional basketball teams (ACB—Spanish league). Participants: A total of 73 male basketball players (mean age 26.8 y). Main Outcome Measures: Patellar tendon ultrasonography images. Pain scores were compared between the identified patterns. Multiple regression analysis was used to examine the relative importance of abnormalities. Results: Of the 146 tendons, 91 had some degree of sonographic abnormality. Three main patterns were identified: I (1 structural abnormality without NV), II (2 structural abnormalities without NV), and III (2 structural abnormalities and NV). A total of 31 tendons (21.2%) exhibited pattern I, 46 (31.5%) presented pattern II, and 13 tendons (8.9%) exhibited pattern III. The mean visual analog scale and the Victorian Institute of Sport assessment questionnaire—patellar tendon (VISA-P) scores for pattern III were significantly different (P Conclusion: Patterns of sonographic abnormalities, including NV, demonstrated greater pain. Although NV determined scores for the visual analog scale, VISA-P, and PPT, the presence of focal area of hypoechogenicity on its own is a determining factor for the PPT. This study suggests that the combination of 2 or more sonographic abnormalities may help explain pain variations among basketball players.

Background: Chronic plantar heel pain (CPHP) is a common condition with high prevalence rates and a projected cost of treatment of US$192 to US$376 million. There are several therapeutic approaches and there is increased interest in treatments aimed at the regeneration of tissues with poor healing potential. Our purpose was to investigate the effectiveness of ultrasound-guided percutaneous needle electrolysis in chronic plantar heel pain. Methods: A total of 73 patients with a clinical and ultrasonographic diagnosis of plantar heel pain unrelated to systemic inflammatory disease who had not received any other treatment in the previous 6 months on the affected foot were randomly allocated to receive either ultrasound-guided percutaneous needle electrolysis of the fascia (experimental group, n = 39) or placebo puncture (control group, n = 34). The primary outcome was pain scored with an 11-point numeric pain rating scale (0 = no pain, 10 = maximum pain). Secondary outcomes were function and disability measured by the 21-item activities of daily living subscale of the Foot and Ankle Ability Measure questionnaire, and fascia thickness measured by ultrasound. Outcomes were measured at 1, 12, and 24 weeks. Results: The mixed-model analysis of covariance observed significant group x time interactions from all variables: pain in numeric pain rating scale ( P < .001), FAAM Activities of Daily Living Subscale scale ( P < .002), and ultrasonographic measures of the plantar heel ( P < .002). Patients in the experimental group had better results posttreatment at 12 and 24 weeks compared with the control group. Conclusion: With chronic plantar heel pain, ultrasound-guided percutaneous needle electrolysis improved pain and function. This treatment may also decrease fascia thickness. Level of Evidence: Level I, randomized controlled trial.

Introduction There is a lack of supporting evidence for conservative treatments involving Morton’s Neuroma, which has often a clinical presentation with many associated complications such as functional impairment and chronic pain. This case study assessed the effects of a combined physical therapy treatment for Morton’s Neuroma, an injury often referred for surgery. Methods The patient suffered a long-standing Morton’s Neuroma and received 6 combined physical therapy sessions that included soft-tissue massage, joint mobilization, strengthening therapeutic exercises and pain education. Values for pain with deep pressure, pain maladaptive beliefs and functionality were taken using clinical testing and questionnaires. Results After the intervention was successfully completed, pain when applying deep pressure resolved. Functionality involving the toe-to-wall test showed an improvement in ankle dorsiflexion and better results were found in both the LEFS and FAAM questionnaires. Pain maladaptive beliefs, assessed with the Pain Catastrophizing Scale and the Pain Awareness Questionnaire also reflected an improvement. Conclusion A combined physical therapy approach shows encouraging results in the treatment of Morton’s Neuroma.

Resumen Objetivo Observar la implicacion que tiene el espacio subacromial medido ecograficamente, y si existen diferencias entre el acromio great trocanter (AGT) y el acromio humeral distance (AHD) en deportistas con dolor de hombro. Material y metodo Se ha realizado un estudio observacional, transversal y comparativo sobre la relacion del espacio subacromial y el dolor del hombro del deportista lanzador. Se ha seleccionado a 81 deportistas hombres que utilizan los miembros superiores en su practica deportiva. Se les practico una ecografia del hombro obteniendo imagenes de la distancia AGT y la distancia AHD. La muestra se dividio en 2 grupos en funcion del dolor durante la practica deportiva. Resultados No se encontraron diferencias estadisticamente significativas en AHD, AGT, diferencia en la AHD entre el grupo sin dolor (GsD) y el grupo con dolor (GD). Sin embargo, se obtuvieron diferencias significativas para la edad (p = 0,010; IC del 95%, –8,41; –1) y para la diferencia en la AGT (p = 0,039; IC del 95%, 0,068-2,654). Se encontro una correlacion significativa (GsD, p = 0,007; GD, p = 0,013) entre la AGT y la AHD aunque con una dependencia moderada (GsD r = 0,395; GD r = 0,412). Conclusiones La distancia AGT es significativamente menor en los sujetos con dolor de hombro y la distancia AHD tiene tendencia a estar disminuida en presencia de dolor. A su vez, la edad es un factor predisponente del dolor de hombro en deportistas. Por lo que se recomienda el estudio de estos valores como dato complementario en la valoracion ecografica del conflicto subacromial.

Introduction Weight training is a useful tool in order to achieve muscular hypertrophy. However, the American College of Sports Medicine (ACSM) recommends intensities of 70% of one repetition maximum (1-RM). Those intensities may not be suitable for everyone because of the high mechanical stresses placed upon the joints [Loenneke, 2012]. Nowadays, it is common to combine low-intensity exercise (20–30% 1-RM) with blood flow restriction (BFR) because of the beneficial effects in increased muscular strength, hypertrophy, localised endurance and cardiorespiratory endurance [Pope, 2013]. Despite there is not many papers about the beneficial of this training, it is know that the tendon suffers some adaptation to physical loading [Heinemeier 2011]. Therefore, the purpose of this study was to investigate the effects of low-intensity (30% 1-RM) concentric exercise combined with BFR in the thickness of Achilles tendon. Methods Twelve college-aged male participants aged 24 ± 4 years and three female aged 27 ± 3 (body mass 25 ± 4, height 178 ± 7 cm, weight 79,0 ± 13 kg) with a minimum of 1 year of strength training experience were recruited for this study. Prior to testing the concentric 1-RM for each leg was determined. For the exercise session, the exercise intensity was set at 30% 1-RM for each leg. The right leg of each subject was included in the occlusive group and the left leg in the control group. The subjects’ occluded legs were wrapped at a 30% of maximum pressure. Subjects performed three sets of 15 repetition of Leg-Press Calf Raise in a leg press machine. The control group (left leg) did the same protocol without BFR. The thickness of Achilles tendon was measure in each subject before the testing, immediately after exercise and 24 h after exercise by ultrasound (Mindray Z6). Results To verify that there are no significant differences between pre and post-24 measures tendon. Wilcoxon test with a significance level of 5% was applied proving that there is no such difference. Discussion The main finding of this research is that the occlusive training did not change the behaviour of the tendon. There is not significant differences between the control group and the occlusive group. Therefore, it is suggest that the occlusive condition does not produce any additional disturbance on tendon. In addition, this training could be useful for individuals with muscular diseases, or those who cannot lift sufficiently high loads to increase muscle size and strength. References Heinemeier et al . J Musculoskelet Neuronal Interac. 2011;11:115–23 Loenneke et al . Med Hypotheses. 2012;78:523–7 Pope et al . J Strength Cond Res. 2013;27:2914–26

Context:The supraspinatus muscle has an important role in the stabilization of the glenohumeral joint. Identifying abnormalities concerning its size and the subacromial space in the presence of pain may be relevant to provide more specific treatments focused on the etiology of pain.Objective:To determinate whether painful shoulder causes changes in the supraspinatus cross-sectional area (CSA) and the acromio-humeral distance (AHD) between overhead athletes.Design:Cross-sectional study.Setting:University campus and local sports clubs’ Physical Therapist room.Participants:81 male overhead athletes were divided into 2 groups according to the presence of shoulder pain and clinical symptoms.Main Outcome Measures:Ultrasonography measurements of the supraspinatus CSA and the AHD in 2 groups of overhead athletes with and without pain.Results:In the pain group, the CSA was significantly smaller compared with the no pain group. No differences between groups were found in the AHD measurement.Conclusions:Shoulder pain in overhead athletes was associated with a reduction in their supraspinatus muscle CSA, but not in the AHD. These findings suggest that muscle atrophy exists in the presence of pain. However, in active overhead athletes, the AHD is not clearly reduced in overhead athletes with shoulder pain. Further studies are needed to understand this condition.