Ejercicio terapéutico en el manejo del latigazo cervical crónico. Una revisión sistemática <span class="so-article-trans-title" dir="auto"> Translated title: Alterations of sensitivity to contrast and stereopsis in workers exposed to aromatic hydrocarbons </span>

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Abstract

RESUMEN Objetivo: El objetivo de este estudio fue realizar una revisión sistemática acerca de los efectos del ejercicio terapéutico en el latigazo cervical. Material y Métodos: Se llevó a cabo una revisión sistemática de la bibliografía, siguiendo la normativa PRISMA, en marzo de 2021 y en las bases de datos PubMed, Medline, Scopus, Cinhal y Web of Science. Resultados: Se obtuvieron un total de 11 ensayos controlados aleatorizados, con una calidad metodológica superior o igual a 6 en la escala PEDro. Los programas de ejercicio empleados se basaron en ejercicios específicos de cuello, solos o en combinación con programas integrales, educación y asesoramiento. Conclusiones: Los ejercicios específicos de cuello pueden beneficiar a los pacientes con latigazo cervical crónico. Añadir educación y enfoque conductual a las terapias no parece tener un beneficio adicional, y la prescripción de ejercicio global no parece tener beneficios significativos.

Translated abstract

ABSTRACT Objective: The aim of this study was to conduct a systematic review of the effects of therapeutic exercise on whiplash. Material and Methods: A systematic review of the literature was carried out, following the PRISMA guidelines, in March 2021 and in the databases PubMed, Medline, Scopus, Cinhal and Web of Science. Results: A total of 11 randomized controlled trials were obtained, with a methodological quality greater than or equal to 6 on the PEDro scale. The exercise programs used were based on specific neck exercises alone or in combination with comprehensive programs, education and counselling. Conclusions: Neck-specific exercises may benefit patients with chronic whiplash. Adding education and behavioral approaches to therapies does not appear to have additional benefit, and global exercise prescription does not appear to have significant benefits.

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Evidence for physiotherapy practice: A survey of the Physiotherapy Evidence Database (PEDro)

Catherine Sherrington, Robert D. Herbert, Anne M. Moseley … (2002)

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Comprehensive physiotherapy exercise programme or advice for chronic whiplash (PROMISE): a pragmatic randomised controlled trial.

Zoe A Michaleff, Chris Maher, Chung-Wei Lin … (2014)

Evidence suggests that brief physiotherapy programmes are as effective for acute whiplash-associated disorders as more comprehensive programmes; however, whether this also holds true for chronic whiplash-associated disorders is unknown. We aimed to estimate the effectiveness of a comprehensive exercise programme delivered by physiotherapists compared with advice in people with a chronic whiplash-associated disorder. PROMISE is a two group, pragmatic randomised controlled trial in patients with chronic (>3 months and <5 years) grade 1 or 2 whiplash-associated disorder. Participants were randomly assigned by a computer-generated randomisation schedule to receive either the comprehensive exercise programme (20 sessions) or advice (one session and telephone support). Sealed opaque envelopes were used to conceal allocation. The primary outcome was pain intensity measured on a 0-10 scale. Outcomes were measured at baseline, 14 weeks, 6 months, and 12 months by a masked assessor. Analysis was by intention to treat, and treatment effects were calculated with linear mixed models. The trial is registered with the Australian New Zealand Clinical Trials Registry, number ACTRN12609000825257. 172 participants were allocated to either the comprehensive exercise programme (n=86) or advice group (n=86); 157 (91%) were followed up at 14 weeks, 145 (84%) at 6 months, and 150 (87%) at 12 months. A comprehensive exercise programme was not more effective than advice alone for pain reduction in the participants. At 14 weeks the treatment effect on a 0-10 pain scale was 0·0 (95% CI -0·7 to 0·7), at 6 months 0·2 (-0·5 to 1·0), and at 12 months -0·1 (-0·8 to 0·6). CNS hyperexcitability and symptoms of post-traumatic stress did not modify the effect of treatment. We recorded no serious adverse events. We have shown that simple advice is equally as effective as a more intense and comprehensive physiotherapy exercise programme. The need to identify effective and affordable strategies to prevent and treat acute through to chronic whiplash associated disorders is an important health priority. Future avenues of research might include improving understanding of the mechanisms responsible for persistent pain and disability, investigating the effectiveness and timing of drugs, and study of content and delivery of education and advice. The National Health and Medical Research Council of Australia, Motor Accidents Authority of New South Wales, and Motor Accident Insurance Commission of Queensland. Copyright © 2014 Elsevier Ltd. All rights reserved.

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Is Open Access

Cálculo del tamaño de la muestra en investigación en educación médica

José García-García, Arturo Reding-Bernal, Juan Lopez-Alvarenga (2013)

Un aspecto importante en la metodología de la investigación, es el cálculo de la cantidad de participantes que deben incluirse en un estudio. El tamaño de muestra permite a los investigadores saber cuántos individuos son necesarios estudiar, para poder estimar un parámetro determinado con el grado de confianza deseado, o el número necesario para poder detectar una determinada diferencia entre los grupos de estudio, suponiendo que existiese realmente. El cálculo del tamaño de la muestra es una función matemática que expresa la relación entre las variables, cantidad de participantes y poder estadístico. La muestra de un estudio debe ser representativa de la población de interés. El objetivo principal de seleccionarla es hacer inferencias estadísticas acerca de la población de la que proviene. La selección debe ser probabilística. Los factores estadísticos que determinan el tamaño de la muestra son: hipótesis, error alfa, error beta, poder estadístico, variabilidad, pérdidas en el estudio y el tamaño del efecto. Se revisan las fórmulas utilizadas para el cálculo del tamaño de la muestra en las situaciones más frecuentes en investigación, así como la revisión de fórmulas para un cálculo más rápido. Se incluyen ejemplos de investigación en educación médica. También se revisan aspectos importantes como: tamaño de la muestra para estudios piloto, estrategias para disminuir el número necesario de sujetos, y software para el cálculo del tamaño de muestra.

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Author and article information

Journal

Journal ID (publisher-id): medtra

Title: Revista de la Asociación Española de Especialistas en Medicina del Trabajo

Abbreviated Title: Rev Asoc Esp Espec Med Trab

Publisher: Asociación Española de Especialistas en Medicina del Trabajo (Madrid, Madrid, Spain )

ISSN (Print): 1132-6255

ISSN (Electronic): 3020-1160

Publication date (Print and electronic): 2021

Volume: 30

Issue: 4

Pages: 520-536

Affiliations

[3] Galicia orgnameUniversidade de Vigo orgdiv1Facultad de Fisioterapia Spain

[1] Galicia orgnameUniversidade de Vigo orgdiv1Facultad de Fisioterapia Spain

[4] Galicia orgnameUniversidade de Vigo orgdiv1Facultad de Fisioterapia Spain

[2] Galicia orgnameUniversidade de Vigo orgdiv1Facultad de Fisioterapia Spain

Article

Publisher ID: S3020-11602021000400520 Publisher ID: S3020-1160(21)03000400520

SO-VID: 5cd9fb65-3d03-424e-b871-500980f426bd

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This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.

History

Date accepted : 20 December 2021

Date received : 02 September 2021

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Figures: 0, Tables: 0, Equations: 0, References: 27, Pages: 17

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Ejercicio terapéutico en el manejo del latigazo cervical crónico. Una revisión sistemática Translated title: Alterations of sensitivity to contrast and stereopsis in workers exposed to aromatic hydrocarbons

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Most cited references 27

Evidence for physiotherapy practice: A survey of the Physiotherapy Evidence Database (PEDro)

Comprehensive physiotherapy exercise programme or advice for chronic whiplash (PROMISE): a pragmatic randomised controlled trial.

Cálculo del tamaño de la muestra en investigación en educación médica

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