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.::. Kinesiología y Práctica Basada en Evidencia.::.

Práctica Basada en la Evidencia, aplicada a la Kinesiología

Updated: 2018-03-05T16:08:41.069-08:00


A Massage Therapist's Guide to Pathology, 5th Edition


Interesante Libro: Review: A Massage Therapist's Guide to Pathology, 5th Edition by Ruth Werner English | 2012 | ISBN: 1608319105 | 663 pages | PDF | 25.27 MB This cornerstone book of the massage curriculum is the most comprehensive, visually appealing, and respected title to cover the pathologies that massage therapists must be familiar with. In the fifth edition, Ruth Werner's A Massage Therapist's Guide to Pathology the focus on not only explaining the disease, but also its applicability and indications in massage therapy. This text offers detailed information on the etiology, signs, symptoms, and treatment of more than 500 diseases and conditions, and also helps students discover how massage therapy influences the healing process. Organized by body system, the text features case histories in which people living and coping with many of the disease conditions covered in the text share their stories. Key Features - An enhanced art program, featuring illustrations that capture the reader’s attention and make difficult concepts easier to grasp - A new Conditions at a Glance appendix to provide concise information on an additional 34 diseases - There’s also a new table at the end of each disease condition summarizing the benefits, risks, and options for massage therapy - Case histories share stories of people living with conditions covered in the text to draw a real-world connection between the classroom and the clinic - Research literacy appendix addresses the need for evidence-based massage therapy - Compare and contrast charts present similar conditions side-by-side to help students discern the differences This book provides comprehensive, yet concise, information on the etiology, signs, symptoms, and standard treatment approaches for more than 500 diseases and conditions. At the end of each condition, a "Risks, Benefits, Options" table provides guidance on the implications for massage. For this 5th edition, the author has throroughly researched and updated each condition in the text. She has streamlined the information to focus on what is most useful to the massage therapy student, while maintaining the friendly and accessible style that this text is known for. Included with each book is a code for access to a host of games, exercises, quizzes, videos, and animations, all developed or selected by the author. Link:

Mark L. Latash - Neurophysiological Basis of Movement



Mark L. Latash - Neurophysiological Basis of Movement
| ISBN: 0880117567 | 1998-01-15 | PDF | 269 pages | 26.70 Mb

“This is a valuable resource for students and entry-level professionals in fields related to motor control. The author has diligently and successfully critiqued his previous edition to produce a book that can help students learn and teachers facilitate in a critical thinking environment.” -Doody's Book Review Service
--This text refers to an alternate Hardcover edition.
Product Description
Neurophysiological Basis of Movement is the only contemporary comprehensive textbook on the neurophysiology of voluntary movement. The book also covers relevant information from the study of biomechanics, anatomy, control theory, and motor disorders. It emphasizes neurophysiological mechanisms that apply to the processes of voluntary movements. The text covers a semester's worth of material about the neurophysiological aspects of five major areas: cells, reflexes, structures, behaviors, and disorders. Additional topics include basic functional anatomy, physical and chemical foundations of brain functioning in relation to control of voluntary movements, muscle reflexes and spinal connections, basic mechanics of muscle contraction, and the basis of kinesthesia. The book applies these topics to specific tasks such as standing, locomotion, eye movement control, and reaching. The reader-friendly text also features 156 one-minute drills to challenge students' knowledge of the material; 262 illustrations to help students understand the neurophysiological mechanisms necessary for voluntary movements such as standing, locomotion, and reaching; and 6 lab studies that provide hands-on experience. Several motor disorders are discussed, including spinal cord injury and Parkinson's disease, as well as issues of motor rehabilitation. Readers also will appreciate the references that accompany each of five "Worlds" and a glossary for the entire text.


Evidence Based Management of LBP


Evidence-Based Management of Low Back Pain by Simon Dagenais
M o s b y | English | 2011 | ISBN: 0323072933 | 496 pages | PDF | 56,5 MB

"The authors went to great lengths to take a close-up look at a wide array of treatment options and they realized a nearly impossible task of streamlining the bulk of currently available evidence on chronic low back pain. For each treatment, five different sections were created to allow clinicians, patients, third-party payers and other stakeholders to make informed decisions; namely: description, theory, efficacy, safety and costs. This intelligent design was implemented identically for each treatment."

Physical Rehabilitation of Paralysed Facial Muscles: Functional and Morphological Correlates


# Paperback: 155 pages
# Publisher: Springer; 1st Edition. edition (March 1, 2011)
# Language: English
# ISBN-10: 3642181198
# ISBN-13: 978-3642181191

Product Description:

Using a combined morpho-functional approach the author recently found that polyinnervation of the neuro-muscular juction (NMJ) is the critical factor for recovery of function after transection and suture of the facial nerve. Since polyinnervation is activity-dependent and can be manipulated, he tried to design a clinically feasible therapy by electrical stimulation or by soft tissue massage. First, electrical stimulation was applied to the transected facial nerve or to paralysed facial muscles. Both procedures did not improve vibrissal motor performance (video-based motion analysis of whisking), failed to diminish polyinnervation and even reduced the number of innervated NMJ to one fifth of normal values. In contrast, gentle stroking of the paralysed vibrissal muscles by hand resulted in full recovery of whisking. Manual stimulation was also effective after hypoglossal-facial anastomosis and after interpositional nerve grafting. The author concludes that manual stimulation is a non-invasive procedure with immediate potential for clinical rehabilitation following facial nerve reconstruction.

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Exercise and Cancer Survivorship: Impact on Health Outcomes and Quality of Life


Después de unas merecidas vacaciones volvemos el 2011 recargados. Esperamos subir un aporte todas las semanas.

Saludos y que sea de utilidad!


ISBN: 1441911723 | 2010-01-06 | PDF | 238 pages | 1.95 Mb
An increasing number of exercise scientists are applying their skills collaboratively (with medics and physiotherapists) to clinical populations and investigating the effects of exercise in relation to wide-ranging clinical, pathophysiological and psycho-social outcomes. The book is aimed at final year Undergraduate and Master's level students of Exercise Science, who are interested in working with clinical populations such as cancer patients.

Many university Sport and Exercise Science courses in the UK and USA now have modules which are focused on exercise for health, and cover aspects of exercise science which are appropriate for clinical populations. The book would also be a very valuable resource for Undergraduate and Postgraduate Physiotherapy courses and a very useful resource for students of Exercise Science and Physiotherapy, as well as practitioners working with cancer patients.There are an increasing amount of research opportunities for exercise scientists who are interested in working with clinical populations. Furthermore, a considerable amount of Government and Charity research funding is being targeted at active lifestyles and this is helping to generate a new culture of collaboration between exercise scientists and medics. Hence, it is highly likely that an increasing number of students from Sport and Exercise Science courses will pursue careers within the clinical realm in the future. Practicing exercise therapists, clinical exercise physiologists and physiotherapists would also find lots of useful up-to-date knowledge to support their evidence-based clinical practice. This book would also be of interest to informed readers who are themselves undergoing or recovering from cancer treatment

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Orthopedic Physical Assessment Enhanced Edition


Providing additional value, the Enhanced Edition of Orthopedic Physical Assessment has been updated with a full color design for easier navigation and is packaged with an observational gait analysis tool on CD-ROM. This classic offers a straightforward, systematic approach to performing a neuromusculoskeletal assessment and explains the rationale behind various aspects of the assessment. Every joint of the body is covered, and separate chapters cover such specific topics as the principles of assessment, head and face, gait, posture, emergency care, and preparticipation evaluation. Complete and comprehensive in its approach, this outstanding reference covers basic science, clinical applications, and special tests. It also offers unparalleled coverage of the extremities, clear explanations of positions and movements, and extensive use of tables and illustrations including many radiographs to highlight key points. * Generous use of photographs and line drawings bring concepts to life. * Special tests have been highlighted for ease of reference. * Case studies add a real life perspective on assessment.

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Part VI -

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Mark A. Jones & Darren A. Rivett - Clinical Reasoning for Manual Therapists



Publisher: Butterworth-Heinemann; 1 edition (November 21, 2003) | ISBN: 0750639067 | Pages: 460 | PDF | 103,84 MB

Libro extraordinario del australiano Mark Jones. Enseña acerca del razonamiento clínico que se debe realizar en kinesiología.

Que sea de provecho!!!

Centro de Reencuentro de la Mujer Madura con la Salud y Belleza (CRMMSB)




Physiotherapy in Respiratory Care: An Evidence-Based Approach to Respiratory and Cardiac Management


Un libro para los amantes del área Respiratoria

Alexandra Hough, "Physiotherapy in Respiratory Care: An Evidence-Based Approach to Respiratory and Cardiac Management"
Publisher: Trans-Atlantic Publications, Inc. | 2001 | ISBN 0748740376 | PDF | 550 pages | 32.9 MB

This work contains case studies and question-and-answer sections that facilitate student learning. It focuses on social and interpersonal aspects of care and treatment, and is extensively and comprehensively referenced. It adopts a problem solving approach.

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Durante el presente año se realizará la cuarta versión del curso “Actualización en la Rehabilitación de Hombro” en Santiago. En esta versión hemos incorporado nuevas temáticas en relación a evaluación interpretativa con razonamiento clínico, control motor, movilización neural y un enfoque neuromecánico de la articulación de hombro y sus estructuras vecinas, con el fin de entregar innovadoras herramientas de evaluación con un concepto integro-funcional y tratamientos kinésicos basados en evidencia teórica y clínica. Para alcanzar lo anterior hemos diseñado un curso de treinta horas con módulos teóricos y prácticos enfatizando en el uso clínico de estos nuevos conocimientos.

Esperando contar con vuestra presencia

Saludos cordiales

Jorge Torres Soto
Director del Curso

Más Información:

Ficha de Inscripción y programa AQUI

Desgarro de Isquiotibiales


A propósito de lo que le ocurrió a nuestro delantero Humberto Suazo he querido proponer un tema que es interesante y además muy común en los deportistas. Con esto, queremos solucionar algunas interrogantes desde el punto de vista de la evidencia, a la vez que damos un ejemplo de cómo usar la MBE (Medicina Basada en Evidencia) en la clínica diaria.Preguntas:¿El manejo médico que está recibiendo Humberto Suazo, en estos momentos, es lo mejor que existe para la recuperación de un desgarro de isquiotibiales?No.a) Cámara hiperbárica (HBOT en inglés): Existe una revisión Cochrane que investigó los efectos de la HBOT en el DOMS y en lesiones cerradas de tejido blando y plantea lo siguiente: “There was insufficient evidence from comparisons tested within randomised controlled trials to establish the effects of HBOT on ankle sprain or acute knee ligament injury, or on experimentally induced DOMS. There was some evidence that HBOT may increase pain in DOMS. Thus, the use of HBOT in these patients cannot be justified by this review.” Si especificamos para desgarros de isquiotibiales, NO EXISTE EVIDENCIAb) Factores de Crecimiento y/o plaquetas: NO EXISTE EVIDENCIA que los factores de crecimiento aceleren la curación de un desgarro isquiotibial en HUMANOS.¿Con el tratamiento que está recibiendo actualmente, cual es la posibilidad que se vuelva a re-desgarrar?Si el tratamiento que recibe consiste en modalidades físicas varias (US, UT, OC, Láser) elongaciones varias (PNF, estática, dinámica..etc), Masoterapia, Fortalecimiento (concéntrico y/o excéntrico), Entrenamiento del equilibrio y propiocepción, etc… Suazo tiene un 70% DE PROBABILIDAD DE VOLVER A DESGARRARSE.¿Existe otra alternativa de tratamiento mejor? ¿En qué consiste? ¿Con este tratamiento, cual es la posibilidad que se vuelva a lesionar?Sí. Existe un ECA (Ensayo controlado aleatorio) de buena calidad metodológica que es ampliamente citado en revisiones, comentarios clínicos y puestas al día (update) que avala la efectividad de un programa innovador para el tratamiento de desgarros de Isquiotibiales. El programa tiene como nombre PATS (Progressive Agility Trunk Stability) y contrariamente a lo que uno pensaría, se inicia inmediatamente después de la lesión.El programa PATS consiste en ejercicios funcionales que involucran a la “escápula de las piernas”, es decir, a la Pelvis, por lo que aplica los principios del control motor y de activación muscular selectiva en la lesión de isquiotibiales con resultados sorprendentes.Si Humberto Suazo recibiera este tratamiento, la probabilidad de re-lesionarse es de menos del 10% (7.7%) con un seguimiento de 1 AÑO.Estudios científicos de referencia1. Revisión Cochrane acerca de la efectividad de la cámara hiperbárica Programa PATS Pavez UlloaKinesiólogoHospital del TrabajadorUnidad de Medicina Deportiva[...]

Curso Kinesiterapia , Clínica Las Condes


1er Curso Modular Teórico Práctico Kinesiterapia de Extremidades y Columna Vertebral
Organiza Servicio de Rehabilitación y Vida Saludable Clínica las Condes
4 y 5 de Junio del 2010

Auditorio Mauricio Wainer
Clinica las Condes

Clínica las Condes
Biester S.A
Dr. Choice

Colegio de Kinesiólogos

Valor Inscripción: $ 80.000
Información e Inscripción:
610 3255 610 3250

Coordinador Académico
Klgo. Rodrigo Jordán Díaz

Más información

Imagineria motora graduada


Esta técnica es un tema apasionante. Es por ello que les subo una exposición de un Kinesiólogo australiano de categoría como lo es David Butler. En esta exposición se habla de las 3 fases de un programa de imagineria motora graduada y viene con fotos y ejemplos clínicos.

Que sea de provecho!!

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Fundamentos científicos de la práctica kinésica


Estimados a continuación subo un pack de papers bastante actualizados acerca de la curación en los distintos tejidos corporales (huesos, tendones, ligamentos, cartílago, músculos) y su implicancia clínica.

Saludos y que sea de provecho..

PD: si alguien sabe de alguna pegita en la región metropolitana me avisa.. xD

Lista de estudios incluidos en el pack:

Pankaj Sharma and Nicola Maffulli.J. Tendon Injury and Tendinopathy: Healing and Repair. Bone Joint Surg. Am. 87:187-202, 2005.

IAIN H. KALFAS, M.D., F.A.C.S.Principles of bone healing. Neurosurg Focus 10 (4):Article 1, 2001

Hongsen Chiang, Ching-Chuan Jiang. Repair of Articular Cartilage Defects:Review and Perspectives. J Formos Med Assoc 2009;108(2):87–101

K M Khan, A Scott. Mechanotherapy: how physical therapists’prescription of exercise promotes tissue repair. Br J Sports Med 2009;43:247–251

LeAnn M. Dourte, Andrew F. Kuntz, Louis J. Soslowsky. Twenty-Five Years of Tendon and Ligament Research. J Orthop Res 26:1297–1305, 2008

Tero A. H. Järvinen, et al. Muscle Injuries. Biology and Treatment. The American Journal of Sports Medicine, Vol. 33, No. 5. 2005

Tero A.H. Ja¨rvinen, et al. Muscle injuries: optimising recovery. Best Practice & Research Clinical Rheumatology Vol. 21, No. 2, pp. 317–331, 2007


Ayudémonos todos!!



La situación del país en estos momentos es difícil, el terremoto ha sido devastador para el 80% del país, hay mas de 1.500.000 de hogares con daños estructurales, hay una cifra aumentando de muertos y una cifra incalculable aún de desaparecidos.

Quiero manifestar mi completo apoyo a la comunidad afectada y decirles que si necesitan ayuda tanto de mi como de este grupo, cuenten con disponibilidad completa y voluntaria. Creo que como profesionales de la salud debemos ayudar en todo lo que podamos.

Vamos Chile!! hemos superado catátrofes mayores que esta:

Quiero terminar con una cita bíblica que creo será de bendición para todos aquellos que esten sufriendo por esta causa:

"Antes, en todas estas cosas hacemos más que vencer por medio de aquel que nos amó. Romanos 8:37"

Saludos y bendiciones!

Francisco Pavez
Kinesiología Basada en Evidencia

Termoterapia profunda y evidencia científica


Effect of diathermy on muscle temperature,electromyography, and mechanomyography. Muscle Nerve 38: 992–1004, 2008Randomized Controlled Laboratory TrialDiathermy treatments may decrease musculotendinous stiffness, but notabsolute strength or motor control strategies that influence force production. evaluation of pulsed shortwave on knee osteoarthritis using radioleucoscintigraphy: a randomised, double blind, controlled trial. Joint Bone Spine 72 (2005) 150–155Joint inflammation in knee osteoarthritis, measured using radioleucoscintigraphy, was not altered significantly by pulsed shortwave, therefore this therapeutic modality has little or no anti-inflammatory effect on conditions such as osteoarthritis of the knee. Diathermy and Prolonged Stretching Increase Hamstring FlexibilityMore Than Prolonged Stretching Alone.J Orthop Sports Phys Ther 2004;34:13-20.randomized, counterbalanced 2×3×5 repeated-measures designThese results suggest that hamstring flexibility can be greatly improved when shortwave diathermy is used in conjunction with prolonged stretching Effectiveness of Hyperthermia for Supraspinatus Tendinopathy in Athletes: A Short-term Randomized Controlled Study. Am. J. Sports Med. 2006; 34; 1247Hyperthermia at 434 MHz appears safe and effective in the short term for the management of supraspinatus tendinopathy. eVect of spa therapy and short wave therapy in knee osteoarthritis: a randomized, single blind, controlled trial. Rheumatol Int (2007) 27:523–529Our study demonstrated the superiority of arsenical ferruginous spa therapy compared to short wave therapy in the treatment of osteoarthritis placebo controlled double blind trial to evaluate the effectiviness of pulsed short wave therapy for osteoarthritic hip and knee pain. Pain 1996 (67) 121-127Any treatment effect on this patient population appears to have been largely placebo-mediated. No evidence was found therefore the specific effectiveness of pulsed short wave for treatment of osteoarthritic hip or knee pain. of Manual Therapy or Pulsed Shortwave Diathermy in Addition to Advice and Exercise for Neck Disorders: A Pragmatic Randomized Controlled Trial in Physical Therapy Clinics. Arthritis & Rheumatism (Arthritis Care & Research) Vol. 53, No. 2, April 15, 2005, pp 214–222multicenter, 3-arm randomized controlled trialThe addition of pulsed shortwave or manual therapy to advice and exercise did not provide any additional benefits in the physical therapy treatment of neck disorders.[...]

Curso IRA 2005 - Ministerio de Salud


Este sin duda es un aporte de antología. Lejos uno de los mejores.

sin mas preambulos


A propósito de querer ser de primera consulta


Volviendo ya de mis vacaciones, y volcándome de lleno a lo que es la búsqueda de trabajo, aún así seguiré actualizando esta página.A propósito de ser profesionales de primera consulta, uno de los principios básicos para ejecutar esta tarea es saber discriminar cuando un paciente es de nuestras competencias o no; es decir, cuando un dolor lumbar es de origen mecánico y no infeccioso, renal, menstrual, etc.. por ello les subo este libro que anduve buscando por bastante tiempo y unos amigos de USA lo escanearon al fin.Differential Diagnosis for Physical Therapists: Screening for ReferralISBN: 0721606199Author: Catherine C. Goodman & Teresa Kelly SnyderPublisher: SaundersEdition: 4th EditionFormat: PDFSize: 23.3 MBProduct Description:Written by a leading expert in the field, this comprehensive reference text enables users to properly screen for medical disease to make an informed diagnosis. The goal of this proven text is to teach the Physical Therapist how to determine if the patient has a true neuromuscular or musculoskeletal problem and to determine the specific dysfunction or impairment. Now with a new title that reflects a better understanding of the screening process as the first step in making a diagnosis, this text provides students, physical therapy clinicians and physical therapist assistants with a step-by-step approach to client evaluation, which follows the standards of competency established by the American Physical Therapy Association (APTA) related to conducting a screening examination.Table of ContentsSection One: Introduction to the Screening Process1. Introduction to Screening for Referral in Physical Therapy2. Interviewing As a Screening Tool3. Pain Types and Viscerogenic Pain Patterns4. Physical Assessment as a Screening ToolSection Two: Viscerogenic Causes of Neuromusculoskeletal Pain and Dysfunction5. Screening for Hematologic Disease6. Screening for Cardiovascular Disease7. Screening for Pulmonary Disease8. Screening for Gastrointestinal Disease9. Screening for Hepatic and Biliary Disease10. Screening for Urogenital Disease11. Screening for Endocrine and Metabolic Disease12. Screening for Immunologic Disease13. Screening for CancerSection Three: Systemic Origins of Neuromusculoskeletal Pain and Dysfunction14. Screening in the Head, Neck, and Back15. Screening in the Sacrum, Sacroiliac, and Pelvis16. Screening in the Lower Quadrant: Buttock, Hip, Thigh, Groin, and Leg17. Screening in the Chest, Breast, and Ribs18. Screening in the Shoulder and Upper ExtremityAppendicesA. Screening SummaryB. Special Questions to AskC. Special Forms to UseD. Special Tests to PerformScanned PDF optimized and OCR'ed BOOK ONLYBajar aquíoBajar aquío Bajar aquí[...]

Joint Range of Motion and Muscle Length Testing



ISBN: 0721689426
Author: Nancy Berryman Reese & William D. Bandy
Publisher: Saunders
Format: PDF
Size: 25 MB

Product Description
This practical guide provides explanations of the techniques for measuring both joint range of motion and muscle length testing. In addition to the comprehensive coverage of the measurement techniques, this text provides valuable information on measuring norms and a critical review on the reliability of specific tests. It demonstrates the use of the goniometer, inclinometer, and tape measure for the examination of the upper and lower extremities, spine, and temporomandibular joint. Readers will find the most complete information available to date on measurement of joint ROM of the spine, as well as muscle length of the upper and lower extremities.

Table of Contents
Section I: Introduction
Chapter 1. Measurement of Range of Motion and Muscle Length: Background, History and Basic Principles
Chapter 2. Measurement of Range of Motion and Muscle Length: Clinical Relevance

Section II: Upper Extremity
Chapter 3. Measurement of Range of Motion of the Shoulder
Chapter 4. Measurement of Range of Motion of the Elbow and Forearm
Chapter 5. Measurement of Range of Motion of the Wrist and Hand
Chapter 6. Muscle Length Testing of the Upper Extremity
Chapter 7. Reliability and Validity of Measurement of Range of Motion and Muscle Length Testing of the Upper Extremity

Section III: Head, Neck and Trunk
Chapter 8. Measurement of Range of Motion of the Thoracic and Lumbar Spine
Chapter 9. Measurement of Range of Motion of the Cervical Spine and Temporomandibular Joint
Chapter 10. Reliability and Validity of Measurement of Range of Motion for the Spine and Temporomandibular Joint

Section IV: Lower Extremity
Chapter 11. Measurement of Range of Motion of the Hip
Chapter 12. Measurement of Range of Motion of the Knee
Chapter 13. Measurement of Range of Motion of the Ankle and Foot
Chapter 14. Muscle Length Testing of the Lower Extremity
Chapter 15. Reliability and Validity of Measurements of Range of Motion and Muscle Length Testing of the Lower Extremity

A. Capsular Patterns Defined
B. Sample Data Recording Forms
C. Normative Range of Motion for the Extremities and Spine in Adults

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Evidence Based Review of Stroke Rehabilitation: Painful Hemiplegic Shoulder


Shoulder pain resulting from hemiplegia is a common clinical consequence of a focal cerebral insult resulting from a vascular lesion (ie. hemorrhagic or ischemic stroke). Spasticity and hemiplegic shoulder pain are related. Further research is needed before conclusions regarding positioning of the hemiplegic shoulder can be made. There is limited evidence that shoulder slings influence clinical outcomes.



Dos papers interesantes de la revista Fisioterapia Española


Estimados, subo dos papers interesantes de la revista Fisioterapia Española. Uno de neurokinesiología y otro de kinesiología traumatológica.

Espasticidad después de la lesión medular: revisión de los mecanismos fisiopatológicos, técnicas de diagnóstico y tratamientos fisioterapéuticos actuales

Revisión interesante acerca de un tema que es bastante complejo en la clínica.

Efecto del Kinesio taping sobre la respuesta refleja de los músculos bíceps femoral y gemelo externo

Es un estudio de laboratorio interesante que mide los efectos reflejos del k-tape en la musculatura de MMII con EMG de superficie. Los resultados sorpresivamente apoyan lo contrario a lo que dice el creador de la técnica, sin embargo las diferencias no son estadísticamente significativas.

Que sea de provecho!!

Distonia del Escribiente (Writer's Cramp)


Es una condición poco frecuente, que se trata de una distonia focal que afecta principalmente al miembro superior y cintura escapular.

Mientras estuve en CETRAM, me tocó ver a 3 personas con este problema por lo que decidí realizar una búsqueda de la mejor evidencia disponible con respecto al tratamiento de dicha patología.

Aquí les subo 2 papers: uno de fisiopatología para comprender la enfermedad y otro de tratamiento. Como siempre, evidencia de la más alta.




Effects of task-oriented circuit class training on walking competency after stroke: a systematic review


Wevers L, van de Port I, Vermue M, Mead G, Kwakkel G.Effects of task-oriented circuit class training on walking competency after stroke: a systematic review Stroke.2009;40:2450-2459

Center of Excellence for Rehabilitation Medicine Utrecht, Rehabilitation Center De Hoogstraat, Utrecht, The Netherlands.

BACKGROUND AND PURPOSE: There is increasing interest in the potential benefits of circuit class training after stroke, but its effectiveness is uncertain. Our aim was to systematically review randomized, controlled trials of task-oriented circuit class training on gait and gait-related activities in patients with stroke. METHODS: A computer-aided literature search was performed to identify randomized, controlled trials in which the experimental group received task-oriented circuit class training focusing on the lower limb. Studies published up to March 2008 were included. The methodological quality of each study was assessed and studies with the same outcome variable were pooled by calculating the summary effect sizes using fixed or random effects models. RESULTS: Six of the 445 studies screened, comprising 307 participants, were included. Physiotherapy Evidence Database scores ranged from 4 to 8 points with a median of 7.5 points. The meta-analysis demonstrated significant homogeneous summary effect sizes in favor of task-oriented circuit class training for walking distance (0.43; 95% CI, 0.17 to 0.68; P<0.001), gait speed (0.35; 95% CI, 0.08 to 0.62; P=0.012), and a timed up-and-go test (0.26; 95% CI, 0.00 to 0.51; P=0.047). Nonsignificant summary effect sizes in favor of task-oriented circuit class training were found for the step test and balance control. CONCLUSIONS: This meta-analysis supports the use of task-oriented circuit class training to improve gait and gait-related activities in patients with chronic stroke. Further research is needed to investigate the cost-effectiveness and its effects in the subacute phase after stroke, taking comorbidity into account, and to investigate how to help people maintain and improve their physical abilities after their rehabilitation program ends.

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Professionalism in Physiotherapy


Product Description
As the role of the physical therapist widens to include more primary care and diagnostic responsibilities, there is a greater need for a single, up-to-date resource that explores professional roles and developments in this changing field. This new book is the definitive reference on this important topic.

This concise book provides information on every vital area important to professionalism: documentation, law and ethics, and leadership - all in the context of the five roles of the physical therapist as defined by the APTA's Guide to Physical Therapist Practice, 2nd Edition. Readers will find information on the history of professionalism in physical therapy, the five roles of the physical therapist (Patient/Client Manager, Consultant, Critical Inquirer, Educator, and Administrator), the role of the physical therapist in today's health care system, and professional leadership and development. Case studies, "how to lists" and "tips from the field" encourage critical thinking and provide strategies for various issues. The book also offers tips on preparing a portfolio, determining leadership style, and preparing a professional development plan based on the APTA's five roles.

Table of Contents
I. Historical Perspective and Professional Practice Issues
1. The Physical Therapist as Professional
2. The History of the Profession
3. Contemporary Practice Issues
II. The Five Roles of the Physical Therapist
4. Physical Therapist as Patient /Client Manager
5. Physical Therapist as Consultant
6. Physical Therapist as Critical Inquirer
7. Physical Therapist as Educator
8. Physical Therapist as Administrator
III. The Complex Environment of Health Care and Professional Development
9. The Organizational, Political, and Cultural Context of Professionalism in the U.S. Health Care System
10. Professional Development, Leadership, and Exemplary Practice
11. The Future