How do doctors and nurses manage delirium in intensive care units? A qualitative study using focus groups.

Objectives: The aim of this study was to explore the experiences of doctors and nurses caring for patients with delirium in the intensive care unit (ICU) and to describe the process of delirium management.

Setting: This study was performed in 5 ICUs located within 4 hospitals in Madrid (Spain).

Participants: Purposeful sampling was performed which included (1) doctors and nurses working in ICUs, (2) with >1 year experience in the ICU and (3) clinical experience with delirium.

Basilar impression presenting as intermittent mechanical neck pain: a rare case report.

Background: Neck pain is one of the most common musculoskeletal disorders in clinical practice. However neck pain may mask more serious pathology. Although uncommon in most musculoskeletal physiotherapy practices, it is possible to encounter rare and extremely life-threatening conditions, such as craniovertebral congenital anomalies.

Joint Mobilization Enhances Mechanisms of Conditioned Pain Modulation in Individuals With Osteoarthritis of the Knee.

Study Design: An experimental laboratory study with a repeated-measures crossover design.

Background: Treatment effects of joint mobilization may occur in part by decreasing excitability of central nociceptive pathways. Impaired conditioned pain modulation (CPM) has been found experimentally in persons with knee and hip osteoarthritis, indicating impaired inhibition of central nociceptive pathways.

Myofascial Temporomandibular Disorder.

Temporomandibular disorders (TMD) have been discussed for more than 70 years without reaching consensus on causes, etiological factors, pathophysiology, or rationale management. Indeed, TMD pain remains an enigma and a diagnostic and management challenge for many clinicians. Perhaps the many and often conflicting views on TMD pain by different health care providers are routed in professional traditions, personal beliefs, experience, and clinical training.

Tension Type Headache.

Tension type headache (TTH) is the most common headache and it has been discussed for years without reaching consensus on its pathophysiology, or proper rationale management. This primary headache remains a challenge into its management for clinicians. This review aims to provide an updated and critical discussion on what is currently known and supported by scientific evidence about TTH and which gaps there still may be in our understanding of this condition.

The Occupational Profile of Women with Fibromyalgia Syndrome.

The aims of this study were to assess the functional level of women with fibromyalgia; to investigate the differences in the occupational activities between women with fibromyalgia and healthy women; and to analyse the perceived importance of occupational performance during self-care, productivity and leisure activities. A cross-sectional case control study was performed. Twenty women with fibromyalgia and 20 healthy women completed the Functional Independence Measure (FIM), the Canadian Occupational Performance Measure (COPM), a Numerical Pain Rating Scale, the Fibromyalgia Impact Questionnaire and the SF-36 health survey.

Physical therapy for headaches.

Background Headache is the medical problem most commonly observed by neurologists. Non-pharmacological treatments are commonly demanded by individuals with headaches, but their evidence of effectiveness is conflicting. Aim The current review provides an updated discussion on what is supported by current scientific evidence about physical therapies for tension-type headache (TTH), migraine, and cervicogenic headache (CeH), and which gaps there still may be in our understanding of the interventions.

Ultrasound-Guided Percutaneous Electrolysis and Eccentric Exercises for Subacromial Pain Syndrome: A Randomized Clinical Trial.

Objective. To compare effects of ultrasound- (US-) guided percutaneous electrolysis combined with an eccentric exercise program of the rotator cuff muscles in subacromial pain syndrome. Methods.

Muscle Triggers as a Possible Source of Pain in a Subgroup of Tension-type Headache Patients?

Objectives: Tension-type headache (TTH) is a common condition but the underlying etiology is not understood. Episodic TTH may develop into chronic TTH, and some possible triggers may be involved in generation and maintenance. Nociceptive generators and hyperexcitable spots in neck and shoulder regions may to some degree contribute to TTH.

Prevalence of Myofascial Trigger Points in Spinal Disorders: A Systematic Review and Meta-Analysis.

Objective: To retrieve, appraise, and synthesize the results of studies on the prevalence of active and latent myofascial trigger points (MTrPs) in subjects with spinal pain disorders.

Data Sources: The databases PubMed, Embase, and CINAHL were searched, with no date or language restrictions. Search terms included controlled and free-text terms for spinal disorders and MTrPs.

Cervical Muscle Strength and Muscle Coactivation During Isometric Contractions in Patients With Migraine: A Cross-Sectional Study.

Objectives: This cross-sectional study investigated potential differences in cervical musculature in groups of migraine headaches vs. non-headache controls. Differences in cervical muscle strength and antagonist coactivation during maximal isometric voluntary contraction (MIVC) were analyzed between individuals with migraine and non-headache subjects and relationships between force with migraine and neck pain clinical aspects.

Experiencing the body during pregnancy: A qualitative research study among Spanish sportswomen.

The aim of the current qualitative phenomenological study was to describe the body experiences during pregnancy among Spanish elite sportswomen. Twenty Spanish sportswomen with the following criteria were included: (1) aged between 18 and 65 years; (2) had been pregnant during their professional sporting career; and (3) after the end of their pregnancy, had returned to their professional sports career for at least 1 year. A qualitative thematic analysis was conducted.

Short-term effectiveness of spinal manipulative therapy versus functional technique in patients with chronic nonspecific low back pain: a pragmatic randomized controlled trial.

Background Context: Chronic low back pain (LBP) is a prevalent condition associated with pain, disability, decreased quality of life, and fear of movement. To date, no studies have compared the effectiveness of spinal manipulation and functional technique for the management of this population.

Purpose: This study aimed to compare the effectiveness of spinal manipulation and functional technique on pain, disability, kinesiophobia, and quality of life in patients with chronic LBP.

Dry needling for the management of thoracic spine pain.

Thoracic spine pain is as disabling as neck and low back pain without receiving the same level of attention in the scientific literature. Among the different structures that can refer pain to the thoracic spine, muscles often play a relevant role. Trigger points (TrPs) from neck, shoulder and spinal muscles can induce pain in the region of the thoracic spine.

Manual Physical Therapy Versus Surgery for Carpal Tunnel Syndrome: A Randomized Parallel-Group Trial.

Unlabelled: This randomized clinical trial investigated the effectiveness of surgery compared with physical therapy consisting of manual therapies including desensitization maneuvers in carpal tunnel syndrome (CTS). The setting was a public hospital and 2 physical therapy practices in Madrid, Spain. One hundred twenty women with CTS were enrolled between February 2013 and January 2014, with 1-year follow-up completed in January 2015.

Changes in shoulder pain and disability after thrust manipulation in subjects presenting with second and third rib syndrome.

Objective: The purpose of this preliminary study was to investigate changes in shoulder pain, disability, and perceived level of recovery after 2 sessions of upper thoracic and upper rib high-velocity low-amplitude (HVLA) thrust manipulation in patients with shoulder pain secondary to second and third rib syndrome.

Methods: This exploratory study evaluated 10 consecutive individuals with shoulder pain, with or without brachial pain, and a negative Neer impingement test, who completed the Shoulder Pain and Disability Index (SPADI), the numeric pain rating scale (NPRS), and the global rating of change. Patients received 2 sessions of HVLA thrust manipulation targeting the upper thoracic spine bilaterally and the second and third ribs on the symptomatic side.

Direct and Indirect Effects of Function in Associated Variables Such as Depression and Severity on Pain Intensity in Women with Carpal Tunnel Syndrome.

Objective: To determine the direct and indirect effects of function on clinical variables such as age, pain intensity, years of the disease, severity of symptoms, and depression in women with electrodiagnostic and clinical diagnosis of carpal tunnel syndrome (CTS).

Design: A cross-sectional study.

Setting: Patients from an urban hospital referred to a university clinic.

Neuroscience education in addition to trigger point dry needling for the management of patients with mechanical chronic low back pain: A preliminary clinical trial.

The objective of the current study was to determine the short-term effects of trigger point dry needling (TrP-DN) alone or combined with neuroscience education on pain, disability, kinesiophobia and widespread pressure sensitivity in patients with mechanical low back pain (LBP). Twelve patients with LBP were randomly assigned to receive either TrP-DN (TrP-DN) or TrP-DN plus neuroscience education (TrP-DN + EDU). Pain intensity (Numerical Pain Rating Scale, 0-10), disability (Roland-Morris Disability Questionnaire-RMQ-, Oswestry Low Back Pain Disability Index-ODI), kinesiophobia (Tampa Scale of Kinesiophobia-TSK), and pressure pain thresholds (PPT) over the C5-C6 zygapophyseal joint, transverse process of L3 vertebra, second metacarpal, and tibialis anterior muscle were collected at baseline and 1-week after the intervention.

Trigger Point Dry Needling and Proprioceptive Exercises for the Management of Chronic Ankle Instability: A Randomized Clinical Trial.

Objective. To compare the effects of combined trigger point dry needling (TrP-DN) and proprioceptive/strengthening exercises to proprioceptive/strengthening exercises on pain and function in ankle instability. Methods.

Myofascial Head Pain.

Muscle nociception is mainly characterized by local tenderness and referred pain. The neurophysiological basis of muscle pain supports a role of sensitization mechanisms. From a clinical viewpoint, muscle pain is represented by the presence of myofascial trigger points (TrPs).

Effects of mobilization with movement on pain and range of motion in patients with unilateral shoulder impingement syndrome: a randomized controlled trial.

Objective: The purpose of this study was to compare the immediate effects of mobilization with movement (MWM) to a sham technique in patients with shoulder impingement syndrome.

Methods: A randomized controlled trial was performed. Forty-two patients (mean ± SD age, 55 ± 9 years; 81% female) satisfied eligibility criteria, agreed to participate, and were randomized into an MWM group (n = 21) or sham manual contact (n = 21).

Pressure pain sensitivity map of multifocal nummular headache: a case report.

Background: Nummular headache (NH) is most commonly a localized unifocal headache; however, some patients infrequently exhibit multifocal symptomatic painful head areas retaining all features of NH. We present the pressure pain sensitivity map of an adolescent with multifocal NH.

Case Presentation: We describe a case of a 14 year-old-girl with a 3-year history of continuous pain in four rounded areas, all of them with the same size and shape.

Generalized Pressure Pain Hypersensitivity in the Cervical Muscles in Women with Migraine.

Objective: To investigate the differences in pressure sensitivity in the cervical musculature including the upper trapezius, sternocleidomastoid, suboccipital, levator scapulae, and anterior scalene muscles between women with migraine and healthy controls.

Design: Cross-sectional study.

Subjects: Thirty women with migraine and 30 healthy women participated.

Association between muscle trigger points, ongoing pain, function, and sleep quality in elderly women with bilateral painful knee osteoarthritis.

Objective: The objectives of this study were to investigate if referred pain elicited by active trigger points (TrPs) reproduced the symptoms in individuals with painful knee osteoarthritis (OA) and to determine the relationship between the presence of active TrPs, intensity of ongoing pain, function, quality of life, and sleep quality in individuals with painful knee OA.

Methods: Eighteen women with bilateral painful knee OA, aged 79 to 90 years, and 18 matched controls participated. Muscle TrPs were bilaterally explored in several muscles of the lower extremity.

Pain is Associated to Clinical, Psychological, Physical, and Neurophysiological Variables in Women With Carpal Tunnel Syndrome.

Objectives: To investigate potential relationships of clinical (age, function, side of pain, years with pain), physical (cervical range of motion, pinch grip force), psychological (depression), and neurophysiological (pressure and thermal pain thresholds) outcomes and hand pain intensity in carpal tunnel syndrome (CTS).

Methods: Two hundred and forty-four (n=224) women with CTS were recruited. Demographic data, duration of the symptoms, function and severity of the disease, pain intensity, depression, cervical range of motion, pinch tip grip force, heat/cold pain thresholds (HPT/CPT), and pressure pain thresholds (PPT) were collected.