Background In patients with stroke, hemiplegic shoulder pain can be a major problem. One source of shoulder pain can be myofascial trigger points (MTrPs). Objective To determine the prevalence of myofascial trigger points (MTrPs) and the correlation between MTrPs and pain and function in patients presenting with shoulder pain following a stroke. Design Cross‐sectional study. Setting Department of Physical Therapy. Patients Fifty patients with stroke with shoulder pain. Intervention Not applicable. Main Outcome Measurements The prevalence of the MTrPs located in infraspinatus, supraspinatus, teres minor, and upper trapezius was studied, using the diagnosis criteria recommended by Simons et al. The pressure pain threshold was also evaluated. Pain and function were assessed with the Visual Analogue Scale (VAS) and the Disability of the Arm, Shoulder and Hand (DASH) scale, respectively. Results The prevalence of latent MTrPs was 68%, 92%, 40%, and 62% for supraspinatus, infraspinatus, teres minor, and upper trapezius muscle, respectively. The prevalence of active MTrPs was 34%, 50%, 12%, and 20% for supraspinatus, infraspinatus, teres minor, and upper trapezius muscle, respectively. Pain was moderately correlated with the prevalence of latent MTrPs (r = 0.35; P = .01) and active MTrPs (r = 0.31; P = .03) in the supraspinatus muscle. Disability was measured with the DASH scale and was moderately correlated with latent MTrPs in the infraspinatus (r = 0.31; P = .03) and active MTrPs of the supraspinatus (r = 0.32; P = .02). Conclusions This study shows that the prevalence of MTrPs is high in patents following a stroke. MTrPs in this population are moderately associated with pain and function. Level of Evidence II.

Objective To evaluate the effectiveness of the neurodynamic mobilization techniques compared with passive robotic physiologic movement in patients with hand osteoarthritis (OA). Methods We conducted a randomized controlled trial. A total of 72 patients (mean ± SD age 71 ± 11 years) with dominant symptomatic hand OA were randomized in 2 groups, and both received 12 treatment sessions over 4 weeks. The experimental group received neurodynamic mobilization of the median, radial, and ulnar nerves, and the control group received robotic‐assisted passive movement treatment. Both groups also participated in a program of hand stability exercises. Outcome measures included pain intensity, pressure pain thresholds (PPTs), and strength measurements. Group‐by‐time effects were compared using mixed‐model analyses of variance. Results After the intervention, the experimental group had statistically significant, higher PPTs than the control group at the thumb carpometacarpal joint by 0.7 kg/cm2 (95% confidence interval [95% CI] 0.6, 0.8), the median nerve by 0.7 kg/cm2 (95% CI 0.6, 0.7), and the radial nerve by 0.5 kg/cm2 (95% CI 0.3, 0.6); however, the difference was not statistically significant at 3 months postintervention. Although mean values in the experimental group were higher than in the control group at all PPT sites at both assessments, these differences were not statistically significant. The experimental group experienced a statistically significant reduction in pain immediately postintervention, but this was not present at the 3‐month follow‐up. There were no statistically significant differences in pinch or grip strength between groups. Conclusion We found that neurodynamic mobilizations decreased hypersensitivity in patients with hand OA immediately after the intervention; however, differences were no longer present at 3 months. The results suggest that these techniques may have some limited value in the short term but do not have lasting effects.

Objective To examine the effects of high-intensity laser therapy (HILT) on pain sensitivity and motor performance in patients with thumb carpometacarpal (CMC) osteoarthritis (OA). Design Prospective, triple-blinded, randomized, placebo-controlled trial. Setting Private practice, Malaga, Spain. Subjects Forty-three patients (mean ± SD age = 71 ± 12 years) with a diagnosis of thumb CMC OA grade 1–2 were randomized to the control group (N = 21) or experimental group (N = 22). Methods The experimental group (ExpG) received high-intensity laser therapy (HILT), and the control group (ConG) received a placebo treatment. The outcome measures were pain intensity (visual analog scale) and key pinch strength measurements (dynamometer). All outcome measures were collected at baseline, immediately following the intervention, at four weeks, and at 12 weeks following the intervention. Results Analysis of variance revealed a group × time interaction (F = 40.8, P < 0.001) for pain intensity, with those patients receiving LT experiencing a greater reduction in pain compared with those receiving placebo therapy at the end of the intervention (P < 0.001), as well as at 12 weeks after the intervention. Although mean values in the ExpG were higher than in the ConG for key pinch at assessment, these differences were not statistically significant. Conclusions HILT effectively diminishes pain intensity when used as an isolated treatment for patients with thumb CMC OA, but the effect of treatment decreases after 12 weeks.

Objetivos. Diversos estudios muestran el alto consumo de Internet en cualquier edad, generalizándose su uso en todo tipo de ubicaciones debido a la disposición de dispositivos cada vez más móviles, con más prestaciones y conectados a Internet. El objetivo del presente estudio fue analizar la adicción a Internet de los estudiantes de la facultad de Ciencias de la educación de la Universidad de Málaga.Método. Se utilizó un estudio descriptivo y transversal usando como instrumento de recogida de datos un cuestionario online autocontestado, anónimo y voluntario. Respondieron 809 estudiantes (el 18,16% del alumnado).Resultados. Los resultados muestran que el uso de Internet por parte del alumnado universitario es generalizado, fundamentalmente desde ordenadores portátiles y teléfonos móviles, estando en casa y en la universidad, sin diferencias significativas en lo que respecta al género aunque sí con respecto a la edad, siendo los más jóvenes los que presentan más problemas de adicción a Internet.Conclusión. La adicción a Internet no es un fenómeno alarmante en la muestra estudiada, pero sí un hecho al que hay que prestar atención.

Most of the videos viewed that described conservative interventions for CMC OA management have a low level of evidence to support their use. Although patients and novice hand therapists are using YouTube and other online resources, videos that are produced by expert hand therapists are scarce.

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Background Osteoarthritis (OA) of the thumb carpometacarpal (CMC) joint often presents with joint instability and proprioceptive deficits. Proprioception has been found to play an important role in the rehabilitative process. The purpose of this study was to evaluate the effectiveness of a proprioceptive training program on pain and function in individuals with early-stage thumb Carpometacarpal joint OA. Methods A double-blind experimental trial using a 2-group pretest/posttest design was used in this pilot study. Participants had a diagnosis of grade I and II thumb CMC joint OA in their dominant hand and a pain rating of >4/10 on Visual Analogue Scale. Participants received either standard treatment (control group) or standard treatment plus a proprioceptive training program (experimental group). Outcome measures were lateral pinch strength, pain intensity during activities, and proprioceptive response via joint position sense (JPS) testing. Results Twelve individuals (average age of 66.25 years) participated. Both groups had a statistically significant decrease in pain and increase in lateral pinch strength, all occurring with a large effect size but no statistically significant difference between groups. The experimental group experienced a large effect size for JPS testing, whereas the control group experienced a trivial effect size, and there was a statistically significant difference between groups for JPS testing. Conclusions Individuals who completed the proprioceptive training program in this study had an improvement in proprioceptive functioning. This program shows potential for routine inclusion in hand therapy for thumb CMC joint OA; however, additional high-level studies with larger sample sizes are required.

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