DF - Artículos

Psychological Factors, Central Sensitization, and Insomnia as Potential Prognostic Factors for Short-Term Pain and Disability in Patients With Frozen Shoulder: A Multicentric Prospective Single-Cohort Study

2026-04-22T12:47:24Z

Psychological Factors, Central Sensitization, and Insomnia as Potential Prognostic Factors for Short-Term Pain and Disability in Patients With Frozen Shoulder: A Multicentric Prospective Single-Cohort Study Brindisino, Fabrizio; Silvestri, Elena; Fioretti, Alessio; Pulina, Fabrizio; Conteduca, Jacopo; Navarro Ledesma, Santiago; Medeiros Barbosa, Germanna; Struyf, Filip Background: Identifying modifiable prognostic factors is essential for personalizing conservative interventions. Several psychological and systemic variables remain underexplored in the frozen shoulder (FS) population, particularly regarding their prognostic relevance for short-term changes in pain and disability. Aim: To estimate the prognostic value of psychological factors, central sensitization, and sleep disturbances in predicting clinical outcomes after 3 months of standardized conservative treatment. Method: This multicenter, prospective cohort study was reported following the REMARK statement. Individuals were recruited between July and September 2025. Baseline demographic and clinical variables such as pain catastrophizing, state and trait anxiety, fear-avoidance beliefs (for Work and Physical Activity), central sensitization signs and symptoms, and insomnia were collected at baseline as potential prognostic factors. Shoulder pain and disability (measured with the SPADI subscores) served as outcome variables. Patients underwent a standardized multimodal conservative management for 3 months. Univariable and multivariable linear regression analyses were performed to examine associations between potential prognostic factors and SPADI pain and disability scores at 3-month follow-up. Results: Eighty participants were included. Trait anxiety emerged as the sole significant prognostic factor for shoulder pain (exp (β) = 1.21, 95% CI 1.06–1.38), while state anxiety significantly predicted disability (exp (β) = 0.83, 95% CI 0.73–0.95). The removal of outliers during sensitivity analysis eliminated the statistical significance of all potential prognostic factors when SPADI pain was the outcome. Regarding disability, however, state anxiety remained a significant prognostic factor (exp(β) = 0.86; 95% CI: 0.74–0.99). Discussion and Conclusion: Baseline trait and state anxiety showed prognostic relevance for short-term pain and disability outcomes in patients with FS receiving conservative care. Pain catastrophizing, fear-avoidance behavior, central sensitization, and insomnia did not show significant associations in this cohort. These findings underscore the importance of incorporating psychological profiling, particularly anxiety assessment, into the clinical evaluation and prognostic reasoning for patients with FS.

Agreement Between Face-to-Face and Tele-Assessment of Shoulder Function and Clinical Impairment in Female Handball Players with Previous Shoulder Injury

2026-04-16T08:28:15Z

Agreement Between Face-to-Face and Tele-Assessment of Shoulder Function and Clinical Impairment in Female Handball Players with Previous Shoulder Injury Martin Núñez, Javier; Calvache Mateo, Andrés; López López, Laura; Jiménez López, Rafael; Guo Liang, Jiawi André; Valenza, Marie Carmen; García Ríos, María Del Carmen Background: Shoulder injuries are highly prevalent in handball due to repetitive overhead actions and high mechanical demands, particularly in athletes with a history of previous injury who remain at increased risk of recurrence. Reliable monitoring of shoulder function is essential, and tele-assessment has emerged as a potential alternative to traditional face-to-face evaluation. The aim of this study was to evaluate the level of agreement between face-to-face and tele-assessment methods for measuring shoulder range of motion, dynamic stability, muscular endurance, and scapular dyskinesia in female handball players with a history of shoulder injury. Methods: A cross-sectional agreement study was conducted in 25 competitive female handball players with a history of shoulder injury. Each participant underwent two evaluations (face-to-face and videoconference-based) performed by experienced physiotherapists in randomized order within the same session. Outcomes included shoulder range of motion, dynamic stability assessed by the Upper Quarter Y Balance Test, muscular endurance, and scapular dyskinesia. Agreement between methods was analyzed using two-way random-effects intraclass correlation coefficients. Results: Excellent agreement was observed for range of motion, dynamic stability, and muscular endurance (ICC = 0.96–1.00), with narrow confidence intervals. Scapular dyskinesia demonstrated good agreement (Cohen’s Kappa coefficient 0.59 (p < 0.05)). Mean differences between face-to-face and tele-assessment were minimal, ranging from 0.04° to 0.31° for ROM and 0.10 cm to 0.16 cm for stability measures. Conclusions: Tele-assessment provides clinically comparable results to in-person evaluation and may represent a feasible and reliable tool for remote monitoring of shoulder function in female overhead athletes with a history of injury.

The differences between pain, fatigue, physical fitness, functional status, and family functioning pre- to post- coronary artery bypass grafting among Palestinians

2026-04-08T10:18:59Z

The differences between pain, fatigue, physical fitness, functional status, and family functioning pre- to post- coronary artery bypass grafting among Palestinians Sawalha, Osama; Ariza Vega, María Patrocinio; Alhalaiqa, Fadwa; Ahmad, Hamza; Romero Ayuso, Dulce Nombre de Mari This study aimed to examine pre- to post-operative changes in pain, fatigue, physical fitness, functional status, and family functioning among 200 Palestinian patients (mean age 67; 42% women) undergoing Coronary Artery Bypass Grafting. Validated Arabic versions of the NPRS, FSMC, IFIS, FIM, and APGAR Family Index were administered before surgery and again 2–3 weeks postoperatively. Pain scores differed significantly between pre- and postoperative assessments for both men (t = 11.54, p < 0.001) and women (t = 7.91, p < 0.001). Fatigue increased significantly among men (t = −2.66, p = 0.009) but showed no significant change among women (t = 0.71, p = 0.477). Physical fitness declined in both genders (men: t = 2.25, p = 0.027; women: t = 2.13, p = 0.036). Functional status showed mixed postoperative changes across domains, while total FIM scores remained largely stable. Family functioning improved significantly for both men (t = −3.08, p = 0.003) and women (t = −2.15, p = 0.034). Correlation analyses revealed a moderate positive association between pain and fatigue (r = 0.55, p = 0.01), and inverse associations between physical fitness and both pain (r = −0.42, p = 0.03) and fatigue (r = −0.57, p = 0.02). Functional status correlated positively with physical fitness and family functioning. These findings provide a descriptive overview of early postoperative changes following CABG and highlight gender-specific patterns across key recovery indicators.

Epidemiology, Incidence, Prevalence, and Treatment of Injuries in Padel: A Scoping Review

2026-03-12T11:44:19Z

Epidemiology, Incidence, Prevalence, and Treatment of Injuries in Padel: A Scoping Review Aguilar Nuñez, Daniel; González Romero, Alejandro; Pérez Montilla, José Javier; Hamed-Hamed, Dina; González Muñoz, Ana; Navarro Ledesma, Santiago Padel has gained considerable popularity in recent years; however, the characteristics of padel-related injuries characteristics and epidemiological estimates remain poorly defined. This scoping review aimed to describe the epidemiology, incidence, and prevalence of injuries in padel reported following PRISMA extension for scoping reviews (PRISMA-ScR) guidelines. The literature search was conducted between January and June 2025, and studies published within the last five years were eligible for inclusion. Studies were identified through PubMed, SCOPUS, and SPORTDiscus. Methodological quality was assessed using the Newcastle–Ottawa Scale (NOS) for observational and cohort studies and AMSTAR-II for systematic reviews. Fourteen studies including 3581 players were analyzed. In the upper limbs, the elbow was the most commonly injured region, followed by the shoulder, with a predominance of tendinous injuries, particularly involving the extensor carpi radialis brevis tendon. In the lower limbs, the knee and ankle were the most affected joints, with ligament injuries being the most frequent, mainly involving the anterior cruciate ligament and the posterior talofibular ligament, respectively. Padel shows a high incidence and prevalence of injuries, with limited evidence regarding treatment. This review provides a structured overview of injury patterns in padel that may inform clinicians and coaches when prioritizing prevention and conditioning strategies, while highlighting the need for prospective, standardized injury surveillance and padel-specific intervention research.

Benefits of Physiotherapy Interventions in Survivors of Childhood Cancer: A Systematic Review with Meta-Analysis

2026-03-09T09:19:29Z

Benefits of Physiotherapy Interventions in Survivors of Childhood Cancer: A Systematic Review with Meta-Analysis Ortiz Comino, Lucía; Abril Mera, Tania María; Fernández-Gualda, Miguel Ángel; Lozano Lozano, Mario; Herbawi, Fahed; Fernández Lao, Carolina Background: Survival rates of pediatric and childhood cancer are about 80% in 5 years, which suggests that side effects may appear a while after oncological treatment and can be associated with other health impairments. Early rehabilitation interventions, such as exercise-based physiotherapy, help reduce side effects and maintain an adequate physical condition, thereby improving daily capacity and health-related quality-of-life (HRQoL). The purpose of this systematic review with meta-analysis is to demonstrate which are the most common strategies performed in child and adolescent survivors of childhood cancer to improve their HRQoL and their physical condition. Methods: Two reviewers searched four databases to identify studies that evaluated the effects of physiotherapy and exercise interventions in child and adolescent survivors of childhood cancer. Results: Nine studies performing different exercise interventions were included. The most commonly evaluated outcomes were HRQoL, fatigue, and depression. Seven studies were included in the meta-analysis, with no significant results achieved. Conclusions: Aerobic interventions are the most common strategies performed in child and adolescent survivors of childhood cancer to improve their HRQoL. Depression and fatigue seem to improve with these interventions, but more research is needed to confirm these results. Our meta-analysis revealed inconsistent results supporting the use of exercise interventions in this population.