Background:Several new rehabilitation modalities have been proposed after anterior cruciate ligament (ACL) reconstruction. Among these, trigger point dry needling (TrP-DN) might be useful in the treatment of myofascial pain syndrome associated with ACL reconstruction to reduce pain intensity, increase knee flexion range and modify the mechanical properties of the quadriceps muscle during late-stage rehabilitation. To date, this is the first randomized clinical trial to support the use of TrP-DN in the early rehabilitation process after ACL reconstruction. The aim of this study was to determine the pain intensity, range of motion (ROM), stability, and functionality improvements by adding quadriceps vastus medialis TrP-DN to the rehabilitation protocol (Rh) provided to subacute ACL reconstructed patients.Methods:This randomized, single-blinded, clinical trial (NCT02699411) included 44 subacute patients with surgical reconstruction of complete ACL rupture. The patients were randomized into 2 intervention groups: Rh (n = 22) or Rh + TrP-DN (n = 22). Pain intensity, ROM, stability, and functionality were measured at baseline (A0) and immediately (A1), 24 hours (A2), 1 week (A3), and 5 weeks (A4) after the first treatment.Results:Comparing statistically significant differences (P ≤ .001; Eta2 = 0.198–0.360) between both groups, pain intensity (at A1), ROM (at A1, A2, and A3), and functionality (at A2, A3, and A4) were increased. Nevertheless, the rest of measurements did not show significant differences (P > .05).Conclusion:Quadriceps vastus medialis TrP-DN in conjunction with a rehabilitation protocol in subacute patients with surgical reconstruction of complete ACL rupture increases ROM (short-term) and functionality (short- to mid-term). Although there was an increase in pain intensity with the addition of TrP-DN, this was not detected beyond immediately after the first treatment. Furthermore, stability does not seem to be modified after TrP-DN.

Purpose: To study the prevalence of UI in female athletes, the category of sports with the highest number of cases, the most incident risk factors and the bio-psycho-social consequences. Methods: Preparation of a survey, based on two validated questionnaires answered by 63 participants, to carry out an analytical, transversal and observational study. All participants were European, adult, female athletes (mean age 30.78 years, standard deviation 12.16 years). Results: UI has a high prevalence (44.4%) in female athletes (compared to 10% in non-athletes), being more frequent in those who practice long-distance running. As age and years of sport practice increase, the incidence of this pathology increases. Absorbent pads are used by more than half of women with incontinence, while the rest wet their underwear. Menopause, childbirth and surgery in the region are risk factors for UI, while the presence of urinary tract infections or candidiasis is not. The results state that urine loss does not cause anxiety or depression, but it does affect sporting life. Conclusions: The prevalence of UI in this study is very high and more common in female athletes and the incidence increases with age and other risk factors. The salient consequence of this study is that urine loss affects their sporting environment, but does not induce depression or anxiety.

(1) Background: Introducing ultrasound-guided dry needling to neurorehabilitation treatments increases the beneficial effects of therapy. The aim of this study was to compare the effects of including an ultrasound-guided dry needling session in neurorehabilitation treatment on spasticity and gait–balance quality versus neurorehabilitation treatment in subjects who had suffered a stroke. (2) Methods: A single-blind, randomized clinical trial was conducted. Thirty-six patients who had suffered a stroke in the right middle cerebral artery signed the informed consent for participation in the study. Twenty patients finally participated and were randomly assigned to the control group (neurorehabilitation treatment) or experimental group (neurorehabilitation treatment plus ultrasound-guided dry needling). Pre-treatment and post-treatment data were collected on the same day. The experimental group (n = 10) first underwent an ultrasound-guided dry needling intervention on the tibialis anterior and tibialis posterior musculature, followed by neurorehabilitation treatment; the control group (n = 10) underwent their corresponding neurorehabilitation without the invasive technique. Pre-treatment and post-treatment measurements were taken on the same day, assessing the quality of balance–gait using the “Up and Go” test and the degree of spasticity using the Modified Ashworth Scale. (3) Results: The patients who received neurorehabilitation treatment plus ultrasound-guided dry needling showed a greater decrease in spasticity in the tibial musculature after the neurorehabilitation treatment session (p < 0.001), improving balance and gait (p < 0.001). (4) Conclusions: An ultrasound-guided dry needling session combined with neurorehabilitation treatment reduced spasticity and improved balance and gait in stroke patients.

Background: The presence of latent myofascial trigger points (MTrPs) in the gluteus medius is one of the possible causes of non-specific low back pain. Dry needling (DN) and ischemic compression (IC) techniques may be useful for the treatment of these MTrPs. Methods: For this study, 80 participants were randomly divided into two groups: the dry needling group, who received a single session of DN to the gluteus medius muscle plus hyperalgesia (n = 40), and the IC group, who received a single session of IC to the gluteus medius muscle plus hyperalgesia (n = 40). Pain intensity, the pressure pain threshold (PPT), range of motion (ROM), and quality of life were assessed at baseline, immediately after treatment, after 48 h, and one week after treatment. Results: Statistically significant differences were shown between the two groups immediately after the intervention, showing a decrease in PPT (p < 0.05) in the DN group and an increase in PPT in the IC group. These values increased more and were better maintained at 48 h and after one week of treatment in the DN group than in the IC group. Quality of life improved in both groups, with greater improvement in the DN group than in the IC group. Conclusions: IC could be more advisable than DN with respect to UDP and pain intensity in the most hyperalgesic latent MTrPs of the gluteus medius muscle in subjects with non-specific low back pain, immediately after treatment. DN may be more effective than IC in terms of PPT, pain intensity, and quality of life in treating latent plus hyperalgesic gluteus medius muscle MTrPs in subjects with non-specific low back pain after 48 h and after one week of treatment.

Background: Health-related quality of life (HRQoL) allows knowing the subject’s feelings in distress and well-being, as well as perception of current and future health. Objective: To assess associations between health-related quality of life, fitness status, and adherence to the Mediterranean diet in Spanish children and adolescents. Methods: A cross-sectional study was carried out in a sample of 305 (47.2% women) children and adolescents aged between 8 and 16 years, in the primary and secondary schools of the province of Ávila (central Spain) (NCT05380674). Subjects were classified according to their quality of life: group 1 (highest quality of life) > group 2 (medium quality of life) > group 3 (lowest quality of life). Results: More participants in group 1 showed higher adherence to Mediterranean diet (70.8%) than other groups (group 2: 55.0%; group 3: 43.4%). It was less likely to find optimal levels of muscle strength as quality of life decreased (OR; 95% CI: group 2: 0.535; 0.303–0.955; and group 3: 0.424; 0.234–0.768). Similar trends were found for speed and agility, but only group 3 showed significant results (OR; 95% CI: group 3: 0.297; 0.162–0.545). Flexibility was also the worst in groups 2 and 3 (OR; 95% CI: G2: 0.403; 0.213–0.762; and group 3: 0.520; 0.282–0.958). Conclusion: High fitness status and adherence to the Mediterranean diet were associated with improved health-related quality of life in schoolchildren of central Spain.

Introduction: During the SARS-CoV-2 pandemic, there has been a decrease in the supervision of the medication of subjects with chronic diseases. Customized automated dosing systems (SPDA) are devices that allow medication to be dispensed and administered, which have proven to be safe and effective for the patient and cost-effective for the healthcare system. Methods: an intervention study was carried out on patients from January to December 2019 in a residential centre for the elderly with more than 100 beds. The economic costs derived from manual dosing were compared with those of an automated preparation (Robotik Technology®). Results: Of the 198 patients included, 195 (97.47%) of them were polymedicated. Of the total of 276 active substances of registered medicinal products, it was possible to include them in the process of automating the preparation of the SPDA 105 active pharmaceutical ingredients. A cost reduction of EUR 5062.39 per year was found using SPDA. Taking into account the active ingredients of emblistable and non-emblistable medicines, the use of SPDA resulted in savings of EUR 6120.40 per year. The system contributed to the detection of cases of therapeutic duplication and reduced the time to prepare the medication. Conclusions: the use of SPDA is a useful and economically profitable strategy for its use in residential centres for the elderly.

Background: Allergic bronchopulmonary aspergillosis (ABPA) is a disease characterized by reversible airway obstruction. The clinical symptomatology involves recurrent episodes predominantly in subjects with asthma, those with cystic fibrosis, and subjects with bronchiectasis. Methods: A respiratory physiotherapy treatment plan of home training with The Acapella DH® provides the oscillatory positive expiratory pressure (OPEP) and POWERbreathe Plus® for two weeks, five days a week, twice a day (10 minutes in the morning and another 10 minutes in the afternoon) and to analyze the effectiveness of respiratory therapy using spirometry, as a treatment for a clinical case suffering from allergic bronchopulmonary aspergillosis, bronchial asthma, and bronchiectasis. Results: The first spirometric assessment carried out on week zero revealed that after the home treatment plan in week one and week two assessments, a significant increase in all spirometric lung function values was assessed with % change, such as Vital Capacity (VC), resulting in week 1 (0.80%) week 2 (1.09%), Tidal Volume (VT) resulting in week 1 (0.91%) week 2 (1.04%), Expiratory Reserve Volume (ERV) resulting in week 1 (1.14%) week 2 (1.24%), Inspiratory Reserve Volume (IRV) resulting in week 1 (0.66%) week 2 (1.04%) and Inspiratory Capacity (IC) resulting in week 1 (0.69%) week 2 (0.71%), together with decreasing respiratory times; inspiratory time (Ti) resulting in week 1 (-0.31%) week 2 (-0.38%), expiratory time (Te) and total inspiratory and expiratory time (Tt) resulting in week 1 (-0.24%) week 2 (-0.31%). Conclusions: A home pulmonary treatment plan with OPEP and POWERbreathe Plus® shows a clear improvement in lung function in subjects with ABPA, bronchiectasis, and asthma, thus improving quality of life.

is a degenerative and chronic disease affecting the joints of the human body. This disease consists of progressive wear and tear of the cartilage, although it also affects other joint structures. 1 The pain produced by OA of the knee is more intense during a period of movement, and this diminishes when there is rest. In cases where knee OA is more severe, the pain occurs even at rest. 2 From an anatomical point of view, the knee is one of the most important joints in the human body, as it is involved in most human movements; it is also a joint that bears heavy loads and high stress, making it susceptible to injury more frequently than other joints. 3,4 Among the risk factors for this ailment are overweight, age, gender, type of work, old injuries, bone mineral density, genetic factors, nutrition, and lifestyles. Each of the above factors contributes differently to disease progression. 5,6 2 | OSTEOARTHRITIS OF THE KNEE Classification of osteoarthritis kellgren and lawrence. 7 GRADE 0: no radiological alterations. GRADE 1: doubtful narrowing of the articular space. Possible osteophytosis. GRADE 2: possible narrowing of the articular space. Osteophytosis. GRADE 3: narrowing of the articular space. Moderate osteophytes. Slight sclerosis. Possible deformity of the ends of the bones. GRADE 4: Marked narrowing of the articular space. Abundant osteophytosis. Severe sclerosis. Deformity of the ends of the bones. 3 | OBJECTIVES • To develop a treatment plan for a knee OA patient based on the scientific literature.