NEUROUSAL. Artículos

El movimiento para esculpir el cerebro: fisioterapia basada en neurociencia

Tue, 01 Jul 2025 00:00:00 GMT

La fisioterapia neurológica se ha consolidado como un elemento clave en la rehabilitación de personas con enfermedades y lesiones neurológicas (ictus, esclerosis múltiple, Parkinson, lesiones medulares), que constituyen la primera causa de discapacidad a nivel mundial. Su objetivo principal es restaurar o compensar funciones afectadas para mejorar la autonomía y la calidad de vida de los pacientes. Los avances recientes en neurociencia (plasticidad neuronal, neurogénesis, estudio de redes neuronales y conectividad cerebral) han transformado los enfoques terapéuticos. Se ha demostrado que el movimiento, ya sea real, imaginado u observado, activa procesos neurofisiológicos esenciales para la recuperación motora y cognitiva. Las técnicas tradicionales (Bobath, Vojta, facilitación neuromuscular) conviven hoy con intervenciones innovadoras como la imaginería motora, la observación de acciones, la estimulación cerebral no invasiva y la realidad virtual. Estas últimas permiten aumentar la información sensorial procesada por el cerebro y promover la reorganización neuronal. La evidencia sugiere que dispositivos robóticos y exoesqueletos, junto con la estimulación eléctrica funcional y la estimulación magnética transcraneal, pueden mejorar la plasticidad cerebral y favorecer la recuperación, aunque su investigación clínica está aún limitada por el acceso a tecnología y por la complejidad de registrar la actividad cerebral durante el movimiento. Además, la neurociencia aporta conocimiento fundamental sobre la relación entre emociones y respuesta motora. Estados emocionales intensos pueden interferir en la eficacia de las intervenciones, por lo que estrategias que modulen la respuesta límbica, así como la empatía terapéutica, resultan determinantes. La editorial subraya que el futuro de la neurorrehabilitación pasa por investigar en profundidad los mecanismos neurofisiológicos que sustentan cada técnica, integrar la evidencia científica con la práctica clínica y apostar por un enfoque holístico que contemple tanto los aspectos motores como los emocionales del paciente.

Inspiratory muscle training in adults with cerebral palsy: long term effects: a double-blind randomized, controlled trial

Fri, 20 Jun 2025 00:00:00 GMT

[EN] Respiratory disease is one of the main causes of morbidity and mortality in adults with cerebral palsy (CP). The main objective of the study was to investigate the maintenance over time of improvements in respiratory parameters achieved with inspiratory muscle training (IMT). This was a randomized, controlled, double-blind trial and with allocation concealment performed on 27 institutionalized CP patients randomly distributed in two groups: "high intensity training group" (HIT) trained with a load of 40% of the maximum inspiratory pressure (MIP) and "low intensity training group" (LIT) with 20%. Respiratory strength and pulmonary function were evaluated throughout the study. Four weeks after IMT most improvements persisted. Twelve weeks after IMT, only HIT maintained significant improvements (p = 0.001) in MIP; 24 weeks after IMT, in the HIT group, MIP was 10% higher than the initial results and pulmonary function parameters were 1% lower. In the LIT group, respiratory strength and pulmonary function were lower than at baseline. Improvements achieved with IMT are reduced over time once the treatment ends. During the first 4 weeks posttreatment, the benefits persist but from the 12th week there was a progressive loss of the improvement reaching a total loss at 24 weeks. To be most effective, a higher MIP load is suggested for respiratory treatment, which must be maintained over time and interruptions should not be longer than 4 weeks. Clinical trial registration. The study was registered in the clinical trials database of the United States National Library of Medicine (www.clinicaltrials.gov) with the number of registration NCT04915170.

Brief-Bestest vs. Berg Balance Scale para valorar el equilibrio

Mon, 01 Jul 2024 00:00:00 GMT

Introducción: El equilibrio es una de las capacidades afectadas en los pacientes que han sufrido un ictus. Es imprescindible contar con las herramientas adecuadas para su valoración. El material necesario o el tiempo de aplicación pueden condicionar el uso de unas u otras. Objetivos: Conocer la correlación existente entre las escalas Brief-BESTest y Berg Balance Scale en pacientes que han sufrido un ictus.

Herramientas de evaluación clínica del equilibrio en pacientes neurológicos

Mon, 01 Jan 2024 00:00:00 GMT

Comunicación Póster sobre las Herramientas de evaluación clínica del equilibrio en pacientes neurológicos, presentada en la XX Jornada de actualización en Fisioterapia.

Realidad virtual en Neurorrehabilitación

Sat, 30 Nov 2024 00:00:00 GMT

Electromyographic response of the abdominal muscles and stabilizers of the trunk to reflex locomotion therapy (RLT). A preliminary study

Sat, 01 Jan 2022 00:00:00 GMT

[ENG]Reflex locomotion therapy (RLT) was developed by Vaclav Vojta in 1954 as a diagnostic and treatment tool. This therapy is mainly used to rehabilitate children with motor disorders and risk of cerebral palsy. It is also used for adults with neurological and motor impairment. RLT is based on specific postures and regular stimulation points through which a series of reflex responses are triggered. The neurophysiological mechanisms of this therapy have recently been discovered. This study aims to objectively evaluate muscular responses at the abdominal level after stimulation in the first phase of reflex rolling by showing, with surface electromyography analysis (sEMG), the muscular activity in trunk stabilizing muscles (rectus abdominis, external oblique, internal oblique, and serratus anterior) before, during, and after the application of RLT. A total sample of 27 healthy subjects over 18 years of age was recruited. An experimental study on a cohort was conducted. Two experimental conditions were considered: stimuli according to the Vojta protocol, and a control non-STI condition. Regarding muscular electrical activity, statistically significant differences were determined in all muscles during right-sided stimulation in the VSTI condition (p < 0.001), but not in the non-STI condition. The mean increase in muscle activity in the VSTI condition during the first stimulation ranged from 7% to 20% in the different abdominal muscles. In conclusion, an sEMG response was observed in the abdominal muscles during stimulation of the pectoral area as described in RLT, compared to stimulation of non-described areas.

Optokinetic stimulation effects in the management of unilateral spatial neglect in patients with chronic stroke: study protocol for a randomised controlled trial

Sun, 01 Jan 2023 00:00:00 GMT

[ENG]Introduction Unilateral spatial neglect (USN) is a stroke complication of stroke. Optokinetic stimulation (OKS) is one of the treatments, but its effects on motor symptoms, such as poverty or alterations in movements on the affected side, are not clear yet. The aim of this study will be to evaluate the OKS effects on the perceptual and postural complications of patients with USN. Methods and analysis Randomised double-blinded clinical trial, with an intervention group that will undergo OKS and a control placebo group. The research will take place at the Faculty of Nursing and Physiotherapy, University of Salamanca, 102 patients older than 18 years with diagnosed USN will participate. The intervention group will receive 2 weekly OKS session for 10 weeks. Virtual reality glasses will be used for the application of a video. The video will project OKS at a preset speed and will request the participant's attention throughout the session. The control group will receive a placebo treatment, through a virtual reality video. The measurement variables will be posturography, Fluff test, line bisection, Fullerton Advance Balance Scale and Diller's cancellation test. Ethics and dissemination This study has been approved by the Ethics Committee University of Salamanca on February 2020 (registration number: 584). All patients in the study will be informed about the objective of the study and will give their written informed consent to participate in the study. The anonymised database will be available from the publication of the results for 10 years in the repository of the University of Salamanca GREDOS (https://gredos.usal.es/). The trial results will be shared with the scientific community at international conferences and by publication in a peer-reviewed journal.

Synergy of muscle and cortical activation through Vojta reflex locomotion therapy in young healthy adults: a pilot randomized controlled trial

Sun, 01 Jan 2023 00:00:00 GMT

[ENG]Background: Vojta Therapy is a neurorehabilitation therapy that allows to activate reflex movement patterns. The scientific literature has shown its ability to generate muscle contractions. The activation of brain neural networks has also been proven. However, the relationship between these processes has not yet been demonstrated. For this reason, the aim of this study is to verify brain activation produced by recording with near-infrared spectroscopy and its relationship with muscle activation produced in the abdominal muscles recorded with surface electromyography. Methods: A total sample of 27 healthy subjects over 18 years of age was recruited. An experimental study on a cohort was conducted. Two experimental conditions were considered: stimuli according to the Vojta protocol, and a control non-stimuli condition. Abdominal muscle activation was measured using surface electromyography, and the activation of the motor cortex was assessed with near-infrared spectroscopy. Results: In relation to the oxygenated hemoglobin concentration (HbO), an interaction between the stimulation phase and group was observed. Specifically, the Vojta stimulation group exhibited an increase in concentration from the baseline phase to the first resting period in the right hemisphere, contralateral to the stimulation area. This rise coincided with an enhanced wavelet coherence between the HbO concentration and the electromyography (EMG) signal within a gamma frequency band (very low frequency) during the first resting period. Conclusions: The results underscore the neurophysiological effects on the brain following tactile stimulation via Vojta Therapy, highlighting increased activity in pivotal areas essential for sensory processing, motor planning, and control. This activation, particularly evident in the Vojta stimulation group, aligns with previous findings, suggesting that tactile stimuli can not only evoke the intention to move but can also initiate actual muscle contractions, emphasizing the therapy’s potential in enhancing innate locomotion and rolling movements in patients with neurological disorders.

Reliability and validity of the spanish version of the memorial symptom assessment scale in oncology patients

Thu, 01 Dec 2016 00:00:00 GMT

Context Memorial Symptom Assessment Scale (MSAS) is a multidimensional tool developed to evaluate frequency, severity, and distress of common symptoms present in cancer patients. Objective To translate the original English version of MSAS and prove the reliability and validity of the Spanish version. Methods MSAS scale was translated into Spanish and administered to 246 cancer patients aged between 18 and 85 years. They attended the Day Hospital to receive chemotherapy. European Organization for Research and Treatment of Cancer Quality of Life Questionnaire–Core 30 and Rotterdam Symptom Checklist were used to test criterion validity. Results TOTAL MSAS, Physical Symptom Subscale (PHYS), Psychological Symptom Subscale (PSYCH), and Global Distress Index (GDI) reported high internal consistency: 0.891, 0.801, 0.825, 0.813, respectively. Exploratory factor analysis identified two-factors structure and confirmatory factor analysis showed good adjustment rates. The emotional functioning subscale of European Organization for Research and Treatment of Cancer Quality of Life Questionnaire–Core 30 highly correlated with PSYCH (r = −0.868; P < 0.001) and GDI (r = −0.810; P < 0.001), whereas social functioning subscale correlated with PSYCH (r = −0.704; P < 0.001) and GDI (r = −0.624; P < 0.001). The PHYS of Rotterdam Symptom Checklist correlated with PHYS (r = 0.876; P < 0.001) and the PSYCH with PSYCH (r = 0.872; P < 0.001). Conclusion The Spanish version of MSAS was determined to be a valid and reliable scale in cancer patients.

Reliability and Validity of the Spanish Version of the Brief-BESTest in Stroke Patients

Mon, 01 Jan 2024 00:00:00 GMT

[EN]Background: Balance disorders and postural control treatments play an important role in fall prevention. The Brief-BESTest is a short-scale employed to evaluate balance and fall risk in different populations. Balance assessment is a fundamental element in patients with Acquired Brain Injury rehabilitation since postural alteration is one of the most frequent sequelae. The objective was to validate the Spanish version of the Brief-BESTest questionnaire in the stroke population. Methods: Subjects of both sexes aged over 18 years with a diagnosis of acute/chronic stroke were included. The BESTest, Mini-BESTest, Brief-BESTest, Berg Balance Scale, and Timed Up & Go Test were used to assess balance. The scales were implemented once. Cronbach’s alpha coefficient was used to assess the internal consistency and confirmatory factorial analysis was employed to assess validity. Results: A total of 44 patients with a mean age of 65.35 years (SD = 10.665) participated. Cronbach’s alpha coefficient showed a high internal consistency with a value of 0.839. In the criterion validity, there was a high positive correlation between the Brief-BESTest and BESTest (r = 0.879), Mini-BESTest (r = 0.808), and Berg Balance Scale (r = 0.711). Conclusion: The Spanish version of the Brief-BESTest scale is valid and reliable, showing adequate psychometric properties for balance assessment in patients with acute or chronic stroke.

Libro de Resúmenes de las II Jornadas de Divulgación Científica NeuroUsal

Fri, 28 Jun 2024 00:00:00 GMT

La alta prevalencia de las lesiones y enfermedades neurológicas y su afectación en el funcionamiento físico, psíquico, emocional y social de las personas que las sufren, justifican la necesidad de desarrollo en el ámbito de la neurorrehabilitación, cuyos avances no sólo mejorarán la eficacia de las técnicas, los métodos o los procedimientos de rehabilitación, sino que otorgarán esperanza y seguridad a los pacientes y a sus familias. Las ponencias incluidas en estas jornadas estuvieron distribuidas en cuatro grupos temáticos. Uno de los paneles estuvo dedicado a las herramientas con enfoque top-down e incluyó una variedad de trabajos innovadores y estudios clínicos sobre el uso de la realidad virtual inmersiva y no inmersiva, los exer-games, imaginería motora y observación de acciones. El segundo de los paneles estuvo dedicado a presentar diferentes enfoques disciplinares en el tratamiento de personas con daño cerebral incluyendo la fisioterapia, psicología, terapia ocupacional, nutrición y logopedia. Completando las líneas principales del Equipo, el tercer panel estuvo dedicado a la visibilización de las herramientas de evaluación en las enfermedades neurológicas. La jornada se completó con un último panel dedicado a la presentación de experiencias en el proyecto de Aprendizaje y Servicio titulado Cuidar al Cuidador”, financiado por la Universidad de Salamanca en su I Convocatoria, año 2023, y cuyo objetivo era abordar el estrés de los cuidadores informales de personas con discapacidad. El compromiso del grupo NeuroUsal con la investigación clínica en neurorrehabilitación se alinea con la necesidad continua de explorar nuevas fronteras en el tratamiento y recuperación neurológica. Cada contribución presentada en estas jornadas es un paso más hacia la comprensión y mejora de las terapias o evaluaciones disponibles, impactando positivamente en la vida de muchos pacientes y sus familias.