bluuebunny/crossref_metadata_2025_split huggingface dataset:
Protocol proposal for the invasive approach of the popliteal muscle
Authors: R. Bosch Janer , B. Togores Morlà , J. Cortés Servera , MM Serrano Barceló 
Published: December 2019

Abstract
Introduction and Aims Considering the difficult access of the popliteal muscle (PM) for manual therapy and the proximity of the neurovascular package, we believe it is necessary to perform an exhaustive study in order to describe the dangers of current techniques for approaching this muscle and in order to develop an approach protocol that ensures safety for patients.
Material and Methods We performed a qualitative search in PubMed using the words: popliteus AND muscle, AND/OR treatment AND/OR dry needling, furthermore we consulted two of the most important scientific references on the technique of dry needling. Concurrently, an ultrasound study was performed with the General Electrics Logiq V2 device, with the patient in side lying on the side to be treated. A sample of 4 subjects was examined, obtaining the following measurements: (M1) Distance between the joint interline of the knee and a point at which sonographically the muscle belly of the PM disappears. (M2) Distance between the joint interline of the knee and a point at which the muscle belly of the PM is more accessible to the direct action of a needle. (M3) Ultrasound distance measured from the point at which the muscle belly of the PM is more accessible and which goes from the element of the neurovascular bundle which is closest until the point at which the needle enters the skin. (M4) Ultrasound distance measured from the point at which the PM is more accessible and which includes the space between the neurovascular bundle and the tibia.
Results We were unable to find results in the Pubmed database search related to invasive techniques for the PM. The technique described by the two leading authors on dry needling of the PM is the same; performed without sonographic guidance, guided by muscle palpation (which can lead to less inter-observer agreement) and with needles of up to 50 mm, which could involve a greater risk of needling the vasculonervous bundle according to the measures obtained (M3 = 3.8 cm). The following mean measurements were obtained: (M1) 8.5 cm (M2) 5.5 cm (M3) 3,8 cm (M4) 1.6 cm.
Conclusions The current approach on the PM has a real and unnecessary danger of invading vascular and nervous structures and harming the patient. The correct invasive technique for the PM should be performed by placing the patient in side lying on the side to be treated with the knee in semi flexion, sonographically assessing the point where access to the PM muscle belly is best by placing the probe parallel the muscle fibers, performing the entrance along the long axis of the probe, with a maximum needle length of 40 mm.
Inflammatory response of two invasive techniques in the mouse with collagenase induced tendinopathy
Authors: JA García Vidal , P. Pelegrín Vivancos , P. Escolar Reina , F. Medina i Mirapeix 
Published: December 2019

Abstract
Background  Percutaneous needle electrolysis (PNE) is a physiotherapy technique which has demonstrated its effectiveness for the treatment of tendinopathies and muscle pathologies. All the authors consulted base its therapeutic effect on the capacity to produce an important inflammatory response during the initial phase of the regenerative process. However, presently, the histological effects of the technique on tendinopathies are unknown. The aim of this study was to histologically examine the inflammatory response provoked by the PNE versus dry needling (DN) in mice with collagenase-induced tendinopathy.
Material and Methods In order to achieve the proposed aim, a murine model was used with a total of 18 C57BL/6J mice. One week prior to the intervention, collagenase-induced tendinopathy was performed in the common calcaneal tendons of all mice. Once the pathology was established, they received DN in the left common calcaneus tendon, whereas, on the right, they received treatment with PNE. Groups of animals were sacrificed at 3, 7 and 14 days to evaluate the histological evolution of injuries. Samples of the common calcaneal tendon were taken and were later fixed in formalin, processed, and included in paraffin blocks. Sections of 3 microns thick were performed, which were dyed using hematoxylin-eosin for conventional histopathological examination.
Results In both groups, tissue damage was observed with collagen fragmentation and the presence of fibroblasts. Dry needling of the common calcaneal tendon induced the presence of an acute inflammatory infiltrate (characterized by the presence of polymorphonuclear neutrophils and macrophages) at the level of the peritenon and adjacent fat tissue which was detectable after day 3, and notable after days 7 and 14. The application of PNE induced a similar effect, although on day 14, the inflammatory infiltrate of PNE was more evident, compared to DN.
Conclusion The proposed in vivo murine model has demonstrated to be useful for the study of the evolution of the first phases of the regenerative process induced by both techniques. The histopathological results reveal that PNE generates a pro-inflammatory stimulus which is superior to DN on day 14.
The use of ultrasound as a research tool in acupunture: a literature review
Authors: M. Sánchez Lorenzo , R. Seoane Pardo 
Published: December 2019

Abstract
Background and Aims Ultrasound is a non-invasive test which enables a fast real time exam, which is both dynamic and accessible. In contrast, the mechanisms of functioning of acupuncture have not been completely understood. The aim of this review was to determine the various uses assigned to ultrasound in acupuncture research.
Material and Methods A literature search was performed in PubMed, Cochrane Library, PEDro and ScienceDirect databases. Manual searches were performed in the following journals: Evidence-Based Complementary and Alternative Medicine, Acupuncture Medicine, Medical Acupuncture and The Journal of Alternative and Complementary Medicine. The search terms “ultrasonography” and “Acupuncture” were used, related with AND. Research studies in humans were included in which ultrasound was used to assess some aspect of the acupuncture intervention. No time limit was established and the languages were limited to Spanish, English, Galician or Portuguese. The data extraction was performed by two independently blinded evaluators.
Results A total of 46 studies were included for the analysis. B Mode is the most used form of imaging, followed by Doppler and elastography. In total, 18 studies performed an analysis of vascular parameters. Doppler was commonly used, with a dominance of transcranial Doppler methods, although B mode was also used to measure the transverse diameter of blood vessels. In 11 studies, B mode was used alone or combined with Doppler to obtain measures of safety, precision, location of target structures and needle position regarding sensitive structures. Seven studies used elastography. Five studies quantified tissue movement and another quantified muscle stiffness using elastography and B mode. A further study also included Doppler for the measurement of blood flow. Six studies evaluated visceral conditions. One study evaluated gastric emptying and the five remaining studies focused on the genitourinary sphere such as the rate of pregnancy, fetal position, prostate characteristics, intrapelvic venous congestion and bladder emptying. From the musculoskeletal point of view, 4 studies were located. Two studies evaluated the thickness parameter of the common extensor tendon of the epicondyle and two layers of connective tissue, respectively. One study concluded that the application of acupuncture can influence the viscoelastic properties of the tendon and one remaining study informed of the positive association between ultrasound as an assessment tool and follow up tool in acupuncture treatments.
Conclusions In this field of study, ultrasound has been used to obtain objective outcomes and adopt safety guidelines related to acupuncture procedures.
Action of galvanic currents on needles during percutaneous needle electrolysis
Authors: R. Margalef , F. Minaya Muñoz , F. Valera Garrido , M. Santafe M. 
Published: December 2019

Abstract
Background The use of galvanic currents (GC), during percutaneous needle electrolysis (PNE) can make needles release metals and therefore decrease their diameter and increase resistance. If this were very marked, this could increase the temperature of the needle during use of the same. Furthermore, the loss of materials such as zinc, can trigger allergic reactions in people who are sensitive to these metals.
Aim to evaluate modifications of needles during the application of GC in PNE.
Methods The resistance was evaluated using a Digital multimeter Velleman DVM92. The GC was generated using the Physio Invasiva device by Prim (3 mA during 3 seconds, 3 applications were performed). For each needle, resistance of the proximal and distal area was evaluated (insertion) and the % of variation was calculated. 20 Physio Invasiva Needles measuring 0.30 × 40mm were evaluated and inserted in mice. A Quante 600 scanningmicroscope was used as well as a microanalysis device based on diffusion by RX Oxford Instruments (Universidad Rovira i Virgili). The protocols used were: A) 3mA during 3 seconds and 3 applications (Physio Invasiva by BRUMA Center-Tarragona (6 needles) and from the MV Clinic-Madrid (9 needles) in humans and from the UHN laboratory UHN (10 needles) in animals; B) 3mA during 3 seconds and 10 applications, 5 needles were evaluated in animals; C) 3mA during 3 seconds and 50 applications, 5 needles were evaluated in animals.
Results No change was obtained in the proximal-distal resistance (0.4% ± 3.33). No loss of any of the metals occurred in the needles subjected to the protocol of 3/3/3 nor the protocol 3/ 3/10. However, in the 3/ 3/10 protocol, statistically significant losses were obtained for all the metals present.
Conclusion Physio Invasiva needles measuring 0.30 × 40mm do not shed metals nor modify their morphology during the intervention, therefore, the needle diameter of the needle does not decrease. Only exceptionally, when the number of applications is large, is there a loss of material.
Acupuncture points and cutaneous perforating vessels identified with thermography
Authors: F. Soares Parreira , M. Pereira Barbosa , D. Álvarez Prats , O. Carvajal Fernández 
Published: December 2019

Abstract
Aim To confirm the presence of perforating cutaneous vessels (PCV) in different acupuncture points (AP) in the upper limb using thermography.
Material and Methods A cross-sectional analytic study in the upper limb of voluntary subjects (n = 7). In total, 91 AP were analyzed, as well as 91 control points (CP), one per each AP. In each subject, first the AP and corresponding CP were marked, and in second place, the real and thermographic images were captured. In the real images, the AP and CP were marked with circles. Thereafter, software was used to fuse the real image with the AP and the CP and the thermographic image with the PCV to observe the presence or lack of the same in the AP and CP.
Results When all the AP and CP were analyzed globally, significant differences were observed among these regarding the proportion of points which coincided with PCV (p 0.001). It is possible to verify that in the AP, the percentage of coincidence with PCV is 68.1% and in the control points this is 41.8%. This relationship is demonstrated by the risk ratio and odds ratio values and the confidence intervals (95%CI). Thus, it was verified that in AP the probability (risk) of coincidence with PCV is 1.63 [1.23; 2.16] times greater to the probability in the CP. In the same manner, due to the odds ratio, it is still possible to observe that in the AP the chance (odds) of coincidence with PCV is 2.98 [1.63; 5.47] times greater to the CP. It is also shown that for the AP the likelihood of coinciding with perforating vessels is 7.50 [1.31; 43.03] times greater compared to coinciding with CP.
Discussion The presence of PCV in the area of AP must be treated with greater care, both due to the physiology of the same as well as its importance in clinical medicine. Although the precise location of the PCV varies, thermography is a useful tool to evaluate a patient and subsequently apply treatment.
Conclusions Overall, a strong statistical difference was found regarding the presence of PCV in the location of AP in the upper limb.
Relationship between the anteroposterior diameter of the patellar tendon. Pain and functionality in volleyball players
Authors: A. Calvo Gonell , L. Macia Soler , J. Moncho 
Published: December 2019

Abstract
Introduction and Aim Overuse injuries in volleyball represent between 50% and 80% of total injuries, of which, 80% are patellar tendinopathies. Volleyball is the sport with the greatest prevalence of patellar tendinopathy, estimated at 44.6%, followed by basketball with 31.9%. The tendon thickness bears a close and direct relationship with abnormal and diffuse images with accumulation of ground substance, and affecting both sexes, although less marked in women.
Aim To determine whether the antero-posterior diameter of the patellar tendon in volleyball players is associated with a greater sensation of pain and reduced functionality.
Material and Methods An observational, descriptive, cross-sectional study on volleyball players. The scores on the VISA-P scale, the visual analog scale (VAS) and, using musculoskeletal ultrasound, the anteroposterior diameter of the patellar tendon at 5 and 10 mm distal to the inferior pole of the patella. Multiple linear regression models were constructed to adjust the effect of the anteroposterior diameter on the VAS and the VISA-P scores.
Results The final sample comprised 112 players. The anteroposterior diameter was greater in men and was significantly associated with scores on the VAS and the VISA-P for both tendons, and therefore, the greater the score of the diameter, the greater the score on the VAS and the lesser the score on the VISA-P.
Conclusions The measurement of the antero-posterior diameter of the patellar tendon using musculoskeletal ultrasound may be useful for the prevention of sports injuries in volleyball players, as it is significantly associated with a greater perception of pain and reduced functionality.
Adverse effects of percutaneous needle electrolysis in carpal tunnel syndrome
Authors: JM Segura León , F. Medina i Mirapeix , F. Valera Garrido 
Published: December 2019

Abstract
Background Percutaneous needle electrolysis is a physical therapy technique which has shown to be useful for the treatment of nerve entrapments. The aim of the present study was to analyze the possible adverse effects and the follow-up pattern after the application of percutaneous needle electrolysis in carpal tunnel syndrome.
Material and Methods A descriptive observational study conducted at the Traumatology Service of the Ciudad Real Hospital, in patients with a medical diagnosis of carpal tunnel syndrome confirmed by electromyography (gold standard).Percutaneous needle electrolysis was applied under ultrasound guidance in the superficial and deep interphase of the median nerve in its passage through the carpal tunnel, applied with a frequency of once every seven days over four weeks.The week after each intervention, the follow-up pattern of the adverse effects variables was gathered, grouped in the following categories: type of adverse effect, moment of appearance, prevalence period, impact and causality.At 1.5 weeks and 6 weeks after the last intervention, the following variables were gathered: presence of painful or hypertrophic scar, stiffness at the level of the wrist, hand or fingers, infection of the wound, alteration of reflex sympathetic trophism, symptoms related with a nerve lesion, symptoms related with a tendon lesion, post intervention effusion. The McNemar test was used for comparative measures between the first, second, third and fourth intervention, without significant variations (p < 0.05).
Results 30 cases participated in the study, of which one subject had to abandon the treatment after the first application because of apprehension in relation to following through with treatment.Of the 117 intervention applied, one vegetative reaction was recorded, which was transitory and without consequences. Pain appeared during the intervention in 96.5% of the interventions, after the intervention pain was present in 56%, whereas pain experienced days after the intervention occurred in 28.4%. No cases required further medical intervention, and there were no irreversible cases, independent of the cause. For the remaining variables, the records were negative in all interventions.No adverse effects were described for any cases at the follow up at 1.5 and 6 weeks post-intervention.
Conclusions No adverse effects were described at the end of the intervention in the short to mid term. Regarding the follow-up pattern, the pain followed a highly homogeneous course, there were no irreversible adverse effects requiring intervention, and no relationship was found with any cause on behalf of the patient.
01 Prediction of Falls in Community-Dwelling Older People using an Accelerometer: The Results of a 1-Year Prospective Study
Authors: Osaka Hiroshi , Fujita Daisuke , Kobara Kenichi , Yoshimura Yosuke , Matsumoto Hiromi , Suehiro Tadanobu 
Published: December 2019

Abstract

Background
Fall preventive exercise for community-dwelling older people in Japan has a certain effect. The purpose of this study was to examine the predictors of fall risk in older people engaging in preventive exercise.

Methods
In this prospective study, we recruited 162 community-dwelling older people. We had them complete a self-report questionnaire containing items on weekly exercise frequency, exercise duration, exercise efficacy, amount of pain, number of diagnosis chronic diseases, health anxiety level, vision impairment, difficulty using the stairs, insomnia, fear of falling, history of falls, and forgetfulness, as well as the Falls Efficacy Scale. Walking speed and trunk acceleration during walking were also measured in all participants. From trunk acceleration, we calculated five gait parameters: fluctuation, weight shift, lateral balance, anteroposterior balance, and rhythm. Participants were classified as fallers or non-fallers according to the incidence of falls over a 1-year period from baseline assessment.

Results
Of all participants, 19 (11.7%) were classified as fallers and 143 (88.3%) as non-fallers. In comparing the fallers and non-fallers, we found significant differences in their exercise duration, exercise efficacy, amount of pain, history of falls, walking speed, and the gait parameters of weight shift and anteroposterior balance. A logistic regression analysis revealed that walking speed (odds ratio: 0.049, 95% confidence interval [CI]: 0.005-0.265, p=0.008) and weight shift (odds ratio: 0.021, 95%CI: 0.000-0.877, p=0.043) were predictors of falls.

Conclusion
The gait parameter of weight shift is the amplitude ratio of the auto-correlation function from vertical acceleration. This gait parameter is an original metrics and might show the temporal structure around the terminal stance. Measurement of gait parameters, in addition to physical performance, using an accelerometer seems beneficial for fall risk identification among community-dwelling older people engaged in fall preventive exercise.
03 Standing Postural Control in the Older Adult using Proposed Virtual Light Touch Contact System
Authors: Shimatani Koji , Sakata Mami , Mitani Ryoma , Shima Keisuke 
Published: December 2019

Abstract

Background
We proposed a novel standing-function evaluation system based on Virtual Light Touch Contact (VLTC). In this approach, virtual partition with virtual inertia, viscosity, stiffness is set around the subject. When the subject touches the virtual partition, virtual force is estimated. And virtual force is feed backed to fingertip in the form of vibrotactile stimulation. Random on/off control of virtual forces from the virtual partition enabled evaluation of standing function based on the presence or absence of somatic sensory stimulation to the fingers.

Purpose
The purpose of this study was to investigate the adults’ postural control during quiet standing using our VLTC system.

Method
The participants were 60 adults (72.7±7.6 y/o). We used our proposed vibrotactile stimulation device and a Kinect 2 sensor (Microsoft) and a Wii Balance Board (Nintendo) are utilized to determine the centre of pressure (COP). We measured quiet standing with closed eyes and legs using a VLTC system. We compered body sway using total sway length (TSL), rectangular area (RA), average velocity (AVel), and average vector (AVec) of COP in each of the 60's, (22 participants) 70's (28 participants), 80's (10 participants).

Results
The TSL and AVel in the 60’s was significantly smaller than that in the 80’s (p&lt;0.05). And the TLS and AVel in the 70's tended to be smaller than that in the 80's (p=0.07). The other parameters were non-significant.

Conclusion
We showed that body sway increased when the old adults were quiet standing with VLTC system. Stability of the human posture by LTC is due to an increased amount of feedback, especially from the somatosensory system, among the system required for postural adjustment. Authors assume that the old adults could not depend on VTC system due to the decreased in fingertip somatosensory function, and the old adult’s body sway was increased.
05 Shoe Insole Intervention to Reduce Falls and Injuries
Authors: Nagano Hanatsu , Sarashina Eri , Mizukami Katsuyoshi , Begg Rezaul 
Published: December 2019

Abstract
Despite a number of strategies to minimise falls risks, older adults tend to avoid voluntary and continuous engagement into interventions without cost effectiveness and simplicity. Shoe-insole modification may be a practical intervention if it alters foot geometry inside a shoe and improves gait patterns to prevent falls. The current study designed a shoe-insole structure with 2.2 dorsiflexion and 4.5 eversion built-in inclinations on the entire insole surface. Ankle dorsiflexion is fundamental for higher swing foot clearance to reduce tripping falls. Eversion support may also regulate excessive lateral foot centre of pressure (CoP) excursion to prevent ankle sprain and associated falls. Three young male participants (Age: 21 ± 3 yrs., Height: 1.70 ±.08m, Body Mass: 65.3 ± 2.65kg) conducted gait testing on an 8m walkway repeatedly to collect 60 step cycles for both non-insole and insole conditions. Optotrak motion capture system (NDI) recorded swing foot clearance at 100 Hz while AMTI force plates obtained ground reaction forces data, therefore CoP movements. Minimum foot clearance (MFC) was defined as the local minimum vertical toe-ground clearance during mid-swing, where higher MFC prevents tripping falls. The tested insole increased MFC by .20cm on average, considered to effectively reduce tripping falls. Lateral CoP excursion (lateral displacement from initial CoP location at heel contact to the most lateral CoP location during the initial phase of loading response) was reduced by 1.18cm (61%) due to insole walking, possibly indicating the lower risk of ankle sprain and sideways balance loss. Despite these positive effects, further validation is necessary with a sufficient sample size including the older population. It is also essential to consider negative aspects of continuous dorsiflexion and eversion support. For example, the tested insole may disturb functionally important supination. Prior to practical use, human trials for a prolonged period of time are required for insole intervention.