ACTRN12612000402842.

It has recently been found that microbes in the gut may regulate brain processes through the gut microbiota–brain axis, which modulates affection, motivation and higher cognitive functions. According to this finding, the use of probiotics may be a potential treatment to improve physical, psychological and cognitive status in clinical populations with altered microbiota balance such as those with fibromyalgia (FMS). Thus, the aim of the present pilot study with a double-blind, placebo-controlled, randomised design was to test whether a multispecies probiotic may improve cognition, emotional symptoms and functional state in a sample of patients diagnosed with FMS. Pain, impact of FMS, quality of life, anxiety and depressive symptoms were measured during the pre- and post-intervention phases; participants also completed two computerised cognitive tasks to assess impulsive choice and decision-making. Finally, urinary cortisol concentration was determined. To our knowledge, this is the first study that explore the effect of a multispecies probiotic in FMS patients. Our results indicated that probiotics improved impulsivity and decision-making in these patients. However, more research is needed to further explore the potential effects of probiotics on other cognitive functions affected in FMS as well as in other clinical populations.

Initiation of rehabilitation within 24 hours after total knee arthroplasty reduces the mean hospital stay and number of sessions required to achieve autonomy and normal gait and balance.

Stress is a nonspecific response of the body to any demand imposed upon it, disrupting the body homeostasis and that manifests with symptoms such as anxiety, depression or even headache. Response, which is quite frequent in the present competitive world. The aim of this review is to explore the impact of stress on gut-microbiota. Firstly, we summarize evidences in which the microbiota composition has changed as response of a stress situation, thus microbiota impact by stress-response. Likewise, we summarize the different interventions that can modulate microbiota and so then could modulate the stress according to the underlying mechanisms that involved the gut-brain axis on the stress. Finally, we show evidence through the gut modulation impact on stress, both preclinical and clinical studies. In conclusion, the influence of stress on gut-microbiota and gutmicrobiota on stress modulation is clear through different stressors, although the preclinical evidence is so extended, the clinical evidence is more limited. A better understanding of the mechanism underlying the stress modulation through the microbiota may open new avenues for the design of therapeutics that could enhance the clinical benefits pursued. Not only on stress, but also on stress-related disorders such as anxiety and depression, both in healthy subjects and in different populations.

Craniosacral therapy improved medium-term pain symptoms in patients with fibromyalgia.