Introduction: The clinical management of Chronic Low Back Pain (CLBP) substantially varying among general practitioners, specialists and physical therapists belonging to the same country, resulting in a wide spectrum of approaches. Objective: To determine how outcome expectations influence conservative treatment of working-age patients with CLBP. Methods: This is a narrative review of studies investigating or reporting an association between patients’ expectation and conservative treatment in patients with CLBP in working-age. Narrative review’s guidelines were followed during the design, research, and reporting. Results: The articles were screened by reading the titles and abstracts or full articles. This process resulted in a total of 5 studies that met the selection criteria and were therefore included in the systematic review and considered eligible for quality assessment through the Critical Appraisal Skills Programme (CASP) tool and PEDro (Physiotherapy Evidence Database) scale. What emerges from the studies included in the review essentially concerned three main topics: (a) the expectations of results, highly influenced by patients’ previous experiences; (b) the expectation concerning the clinical professional which includes the desire to receive information and education about the disorder and (c) those about environment or context. Conclusions: The results of the studies analyzed show that certain patients’ expectations, such as the expectation of tailored training with frequent follow-ups, the hope for the best possible outcomes, realism or resignation regarding pain relief, activity levels, good dialogue and communication, the need to be seen and confirmed as an individual and the desire to receive an explanation for the pain could be related to a better recovery outcomes. 

/pdf/do-patients-expectations-influence-conservative-treatment-in-2bopi170.pdf

Do patients’ expectations influence conservative treatment in Chronic Low Back Pain? A Narrative Review

COVID-19 placed teams of professionals in a hostile and unfamiliar environment where the lack of knowledge of its pathology led to the adaptation of programs used so far for other conditions to try to address the immediate sequelae of COVID-19 infection. That is why the aim of this study was to assess the effects of a multicomponent exercise program (MEP) in improving cardio-respiratory performance, health status, disability due to dyspnea, aerobic capacity and endurance, and the immediate sequelae of COVID-19. Thirty-nine patients referred from different hospital services were included in this study. An intervention of seven weeks with sessions twice a week was carried out, where patients underwent intervallic training sessions followed by strengthening exercises and individualized respiratory physiotherapy exercises. The results of this study show a significant improvement in cardio-respiratory performance, health status, disability due to dyspnea, and aerobic capacity and endurance after intervention; and an increase in health status and reduction in disability due to dyspnea at the 2-year follow-up. In addition, none of the patients had any adverse effects either pre-post treatment or at the 2-year follow-up. Individualized and monitored MEP in survivors of COVID-19 showed positive effects in a pre-post evaluation and the 2-year follow up, improving the immediate sequelae of post-COVID-19 patients. This highlights the importance of the professional background of the rehabilitation teams in adapting to an unknown clinical environment.

/pdf/multicomponent-exercise-program-to-improve-the-immediate-2uxp0rin.pdf

Multicomponent Exercise Program to Improve the Immediate Sequelae of COVID-19: A Prospective Study with a Brief Report of 2-Year Follow-Up

COVID-19 pandemic did not impact all countries in the same way, and in Spain, the percentage of intensive care unit (ICU) and the mortality rate patients has been very high. The present work aims to present the first case of the new Coronavirus-2019 (COVID-19) on March 23, 2020, in Tenerife, Canary Islands, Spain, of a patient on Invasive Mechanical Ventilation (IMV) affected by acute pneumonia which was treated by airway clearance techniques (ACT) thinking that she was not infected with COVID-19, since the first polymerase chain reaction (PCR) test was negative. The subject presented septic shock, hypoxemic encephalopathy, and seizures. Right lung base consolidation and pleural effusion were visible in the echography. The thorax x-ray presented subcutaneous emphysema and pleural effusion in the right base and an alveolar-interstitial opacity pattern in the left. Bilateral crackles and rhonchus were evident in the right lung during the lung auscultation. The airway clearance protocol comprises Cough Assist (CA) and chest compressions. The variables collected were the ventilatory parameters, blood gas analysis, and thorax x-ray description. ACT protocol improves gas exchange and expands consolidated lung areas in this atypical clinical case presented. At that time, this type of treatment was not performed on patients affected by COVID-19, and the next day we found that the patient had improved, coinciding with the second PCR test, which was positive.

https://journals.sagepub.com/doi/pdf/10.1177/2050313X221112507

Spanish experience on the efficacy of airways clearance techniques in SARS-CoV-2 (COVID-19) at intensive care unit: An editorial and case report

Currently, social anomie is a public health problem worldwide since people show behavior that does not conform to the newly established norms. Faced with this, the aim of the study was to develop and validate the psychometric properties of a short scale to assess social anomie in a sample of 406 adults (48% male and 52% female) between the ages of 18 and 62. Validity was evaluated based on internal structure through confirmatory factor analysis (CFA) and reliability through the internal consistency method with the hierarchical omega coefficient. The results indicate that a bi-factor model presents better indexes of adjustment to the data (χ2=62.86; df=25; p=.000; RMSEA=.061 [IC90% .042-.080]; SRMR=.024; CFI=.99; TLI=.99). Furthermore, the bi-factor model presents adequate levels of reliability for the general factor (ωH=.70) and for the affective (ωhs=.32) and behavior (ωhs=.41) dimensions. In conclusion, the study results provide a conceptual and statistical basis for the psychometric development of the SAS-10 scale in subsequent studies. 

Development and Validation of the Social Anomie Brief Scale (SAS-10) Against the New Standards Implemented During the COVID-19 Pandemic

Objective: The purpose of the study will be to evaluate the effect of a rehabilitation program on the improvement of patients with post-COVID-19 musculoskeletal symptoms, as well as to quantify the impact of telemedicine that evaluates the evolution of pain, functionality, and quality of life. Methods: We will carry out a case-control study in post-COVID-19 musculoskeletal symptoms patients who will undergo a multicomponent rehabilitation program, together with an intervention and a follow-up using programmed telemedicine sessions. Data will be collected on the improvement of functional capacity and quality of life, in addition to assessing the evolution of musculoskeletal symptomatology, as well as pain and psychological variables. The telemedicine sessions will improve user adherence and follow-up, and the results are expected to be disseminated to the scientific community during and after the end of the study.

https://f1000research.com/articles/11-898/pdf

Addressing post-COVID-19 musculoskeletal symptoms through telemedicine: A study protocol

Objective: This review aimed to provide an update on the characterization and impact of musculoskeletal pain in COVID-19 survivors. Methods: It is considered articles on subjects who had been recovered from COVID-19 infection after hospitalization (COVID-19 survivors) with secondary musculoskeletal pain. Results: Six articles (one editorial, one consensus statement, one letter to the editor, one case-control study, one cohort study and one review) showed the polyhedral effects of the SARS-CoV-2 on musculoskeletal pain. This short review was not able to clearly identify what the pathogenesis of musculoskeletal pain was in COVID-19 survivors. Conclusion: Preliminary data showed that widespread pain similar to the pattern compatible with pain of musculoskeletal origin could characterize symptoms after SARS-CoV-2 infection.

Musculoskeletal pain related to COVID-19 survivors after hospitalization: A short review Dolor musculoesquelético en supervivientes del COVID-19 tras la hospitalización: Una breve revision

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Musculoskeletal pain related to COVID-19 survivors after hospitalization: A short review Dolor musculoesquelético en supervivientes del COVID-19 tras la hospitalización: Una breve revision