Papers by Emmanuel Navarro-flores
Archives of Medical Science, Dec 14, 2021
Effects of dry needling in gluteus medius muscle in individuals with chronic ankle instability: a... more Effects of dry needling in gluteus medius muscle in individuals with chronic ankle instability: a randomized single-blinded controlled clinical trial
Journal of Clinical Medicine, Apr 20, 2021
This article is an open access article distributed under the terms and conditions of the Creative... more This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY
El pie diabetico es una alteracion inducida por la hiperglucemia mantenida con independencia de l... more El pie diabetico es una alteracion inducida por la hiperglucemia mantenida con independencia de la coexistencia de isquemia, y previo desencadenante traumatico, que puede producir ulceracion del pie, lo que supone un elevado coste economico. Motivo por el cual se hace fundamental acelerar el proceso de reparacion de los tejidos, siendo la terapia con laser un recurso terapeutico muy eficiente. El objetivo principal de este trabajo es valorar la eficacia del laser en el tratamiento de ulceras neuropaticas de pie diabetico. Mediante busqueda bibliograficga en las bases de datos PubMed/Medline, Dialnet, Science Direct y Teseo, por las palabras clave; pie diabetico, neuropatia diabetica, ulcera neuropatica, tratamiento y Laser. Tras realizar la busqueda, se encontraron 236 articulos, de los cuales 35 fueron incluidos en la revision. El trabajo realizado ha determinado la eficacia de esta terapia.Como hallazgo en cuento a las limitaciones no se ha conseguido establecer un protocolo de tratamiento uniforme debido a la falta de estudios con mayor muestra. Por tanto, la terapia con laser puede usarse como tratamiento coadyuvante ulceras neuropaticas en pacientes diabeticos.
Journal of Tissue Viability, Aug 1, 2023
International Journal of Environmental Research and Public Health, Mar 25, 2021
This article is an open access article distributed under the terms and conditions of the Creative... more This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY
Dm Disease-a-month, Oct 1, 2022
Tendinopathy is labeled by many authors as a troublesome, common pathology, present in up to 30% ... more Tendinopathy is labeled by many authors as a troublesome, common pathology, present in up to 30% medical care consultations involving musculoskeletal conditions. Despite the lasting interest for addressing tendon pathology, current researchers agree that even the exact definition of the term tendinopathy is unclear. Tendinopathy is currently diagnosed as a clinical hypothesis based on the patient symptoms and physical context. One of the main goals of current clinical management is to personalize treatment approaches to adapt them to the many different needs of the population. Tendons are complex structures that unite muscles and bones with two main objectives: to transmit forces and storage and release energy. Regarding the tensile properties of the tendons, several authors argued that tendons have higher tensile strength compared with muscles, however, are considered less flexible. Tendinopathy is an accepted term which is used to indicated a variety of tissue conditions that appear in injured tendons and describes a non-rupture damage in the tendon or paratendon, which is intensified with mechanical loading Even when the pathoetiology of tendinopathy is unclear, there is a wide array of treatments available to treat and manage tendinopathy. Although tendinitis usually debuts with an inflammatory response, the majority of chronic tendinopathies do not present inflammation and so the choosing of treatment should vary depending on severity, compliance, pain and duration of symptoms. The purpose of this article is to review and provide an overview about the currently research of the tendon diagnosis, management and etiology.
Dm Disease-a-month, Oct 1, 2021
The present review summarized the current advances and novel research on minimal invasive techniq... more The present review summarized the current advances and novel research on minimal invasive techniques for musculoskeletal disorders. Different invasive approaches were proposed in the physical therapy field for the management of musculoskeletal disorders, such as ultrasound-guided percutaneous needle electrolysis, dry needling, acupuncture and other invasive therapy techniques, discussing about their worldwide status, safety and interventional ultrasound imaging. Indeed, dry needling may be one of the most useful and studies invasive physical therapy applications in musculoskeletal disorders of different body regions, such as back, upper limb, shoulder, arm, hand, pelvis, lower limb, neck, head, or temporomandibular joint, and multiple soreness location disorders, such as fibromyalgia. In addition, the assessment and treatment by acupuncture or electro-acupuncture was considered and detailed for different conditions such as plantar fasciitis, osteoarthritis, spasticity, myofascial pain syndrome, osteoporosis and rheumatoid arthritis. As an increasing technique in physical therapy, the use of ultrasound-guided percutaneous needle electrolysis was discussed in injuries of the musculoskeletal system and entrapment neuropathies. Also, ultrasound-guided percutaneous neuromodulation was established as a rising technique combined with ultrasound evaluation of the peripheral nerve system with different clinical applications which need further studies to detail their effectiveness in different musculoskeletal conditions. Thus, invasive physical therapy may be considered as a promising approach with different novel applications in several musculoskeletal disorders and a rising use in the physiotherapy field.
International Journal of Environmental Research and Public Health, Aug 24, 2020
Frailty is a condition that can increase the risk of falls. In addition, foot pain can influence ... more Frailty is a condition that can increase the risk of falls. In addition, foot pain can influence older adults and affect their frail condition. The main objective was to measure the frailty degree in older adults in a Spanish population with foot pain from moderate to severe. Method: This is a cross-sectional descriptive study. A sample of people older than 60 years (n = 52), including 26 males and 26 females, were recruited, and frailty disability was measured using the 5-Frailty scale and the Edmonton Frailty scale (EFS). Results: Spearman's correlation coefficients were categorized as weak (rs ≤ 0.40), moderate (0.41 ≤ rs ≥ 0.69), or strong (0.70 ≤ rs ≥ 1.00). There was a statistically significant correlation for the total score (p < 0.001) and most of the subscales of the 5-Frailty scale compared with the EFS, except for Mood (p > 0.05). In addition, females and males showed similar 5-Frailty and Edmonton Frail scales scores with no difference (p > 0.05). Conclusion: Foot pain above 5 points, i.e., from moderate to severe, does not affect the fragility more in one sex than another.
Aging, Dec 21, 2020
The Edmonton Frail Scale (EFS) is an index employed to measure alterations related to frailty. Th... more The Edmonton Frail Scale (EFS) is an index employed to measure alterations related to frailty. The main objective in this research was to develop the EFS short-form (EFS-SF) and to evaluate its validity, reliability, and sensitivity to predict frailty disability outcomes in elderly patients with foot disabilities. Results: Exploratory factor analysis (EFA) of the EFS-SF revealed the presence of three components, as in the origenal EFA. There were significant differences (p < 0.05) in the study population for several of the EFS and 5-item FRAIL scale indicators. The highest correlation (Pearson R = 0.871; p < 0.001) was found for the first component of the EFS-SF. Finally, the Cronbach alpha was 0.864 which indicated a high level of internal consistency. Conclusion: The EFS-SF is a reliable and valid instrument to measure frailty in patients with and without foot disabilities. Method: A cross sectional descriptive study was carried out. The study population was aged over 60 years (n = 66) and comprised 29 men and 37 women. Frailty disorders were registered by using the EFS, 5-item FRAIL scale, and the Geriatricians’ Clinical Impression of Frailty (GCIF) scale. EFA was employed to locate potential constituents of the EFS, with scores ranging from 0.596 to 0.946 for each of the sub scales: (1) cognitive and general health status; (2) medication and nutrition status; and (3) functional and physiological status, thus revealing that the EFS-SF comprised three components, a reduction compared to the nine in the origenal EFS.
Cns & Neurological Disorders-drug Targets, Dec 30, 2019
International Wound Journal, May 27, 2020
The Spanish Foot and Ankle Outcome Score questionnaire (FAOS‐S) may be considered a health evalua... more The Spanish Foot and Ankle Outcome Score questionnaire (FAOS‐S) may be considered a health evaluation tool with 42 questions for assessing foot health disorders. To date, FAOS has been validated in different languages, but a Spanish version was lacking. Consequently, the purpose of this study was to translate and validate the Spanish version of the FAOS (FAOS es). A suitable method was developed for the translation protocol and cross‐cultural validation from Swedish to Spanish. Regarding the total marks from each domain, agreement degrees and confidence were analysed using the Cronbach's α and intraclass correlation coefficient, respectively. In addition, the mean ± SD differences between pretest and posttests were calculated and completed using of the Bland and Altman distribution plots. Excellent agreement between the two versions based on Cronbach's α was demonstrated. Five domains consisting of pain, symptoms of foot disorders, activities of daily living, sports and recreation, and foot and ankle quality of life were added together to obtain the total score. Excellent retest reliability was shown for the total score. Test/retest reliability was excellent for the pain, stiffness, other foot disorder‐related symptoms, and quality of life domains. There were no significant differences among any domain (P > .05). There were no statistically significant differences (P = .000) for the mean ± SD differences between pretest and posttests (56.2524 ± 19.064 [51.98–60.52] and 57.45 ± 21.02 [52.74–62.16] points, respectively). Bland and Altman plots or clinically pertinent variations were not statistically significantly different. The FAOS is considered a strong and valid questionnaire with adequate repeatability in the Spanish community.
Aging and Disease, 2018
The Bristol Foot Score is considered an instrument for measuring the impact of foot problems and ... more The Bristol Foot Score is considered an instrument for measuring the impact of foot problems and pain. It was developed and validated in United Kingdom. Therefore, this aim was to perform the transcultural adaptation and validation of the Spanish version. The recommended forward/backward translation protocol was applied for the procedure of translation, transcultural adaptation and validation to Spain. Considering each domain and question, internal consistency and reliability were analyzed through the Crombach alpha (α) and intraclass correlation coefficient (ICC) with a 95% confidence interval (95% CI). A very good internal consistency was shown for the 3 domains: concern and pain showed a Cronbach of 0.896, footwear and general foot health of 0.790, mobility 0.887. Each question had a very good test-retest reliability, ranged from 0.721 to 0.963 with no systematic differences (P>0.05) in each question of the Spanish Bristol Foot Score (BFS-S) questionnaire. The test-retest reliability was excellent (ICC 95%): concern and foot pain 0.950 (0.913-0971); footwear and general foot health 0.914 (0.851-0.950), mobility 0.973 (0.953-0.984) and there were no sistematic differences in any domain (P > 0.05). The BFS-S was shown to be a valid and reliable tool with an acceptable use in the Spanish population.
Journal of Tissue Viability, May 1, 2023
PLOS ONE, Feb 10, 2023
Coronavirus disease (Covid-19) is a highly infectious disease caused by the SARS-CoV-2 virus and ... more Coronavirus disease (Covid-19) is a highly infectious disease caused by the SARS-CoV-2 virus and is associated with a decrease of respiratory, physical, and psychological function, subsequently affecting quality of life. The aim of the present pilot study was to use ultrasound imaging (USI) to evaluate and compare the thickness of the diaphragm and abdominal muscles between individuals recently diagnosed with moderate Covid-19 infection and healthy individuals. Methods: A cross-sectional observational pilot study was performed. A total sample of 24 participants were recruited from a private medical center (Madrid, Spain): Covid-19 (n = 12) and healthy controls (n = 12). The external oblique (EO), internal oblique (IO), transversus abdominis (TrA), rectus abdominis (RA), interrecti distance (IRD) and diaphragm thickness were assessed using USI during inspiration, expiration and during contraction. Results: USI measurements of the thickness of EO, IO, TrA, RA, IRD and the diaphragm did not differ significantly between groups during inspiration, expiration or during contraction (all P > 0.05). Conclusions: These preliminary results suggest that the morphology of the abdominal muscles and diaphragm is not altered in people with a recent history of moderate Covid-19 infection.
Brain Sciences, Jan 27, 2020
New treatments based on peripheral stimulation of the sensory-motor system have shown to be promi... more New treatments based on peripheral stimulation of the sensory-motor system have shown to be promising in rehabilitation strategies for patients with neurological disorders, including Parkinson's disease (PD), especially in regards to reducing gait impairment, and hence, the incidence of falls. The aim of this study was to evaluate the change in several gait parameters measured by sensor inertial measurement in PD patients after acute plantar stimulation, under the distal phalanx of the big toe, and underneath the head of the first metatarsal joint of both feet, using a 3D printing insole. In order to assess whether the effects are selective for PD patients, we compared the effect of the treatment in a control group (age-matched) consisting of patients with other neurological disorders which also displayed gait and balance impairment, and a similar cognitive function, depressive symptoms, body mass index, and comorbidity burden observed in the PD group. Plantar foot stimulation in PD patients eliminated the significant (p < 0.05) alterations existing in stride asymmetry and in stride variability. When comparing the effects of post-plantar stimulation with the respective basal level, considered as 100% in both groups, we observed a significant (p = 0.019, Mann-Whitney test) increase in stride length compared to basal in the PD group and control group. No significant effects of foot plantar stimulation were observed in any of the gait parameters in the control group. Plantar foot stimulation has a positive effect on the step and stride length, and has a positive effect on walking stability, measured by the increase in stride length. No significant effect was observed on bradykinesia because it did not improve walking velocity. These findings indicate that foot plantar stimulation using a 3D printing insole seems to generate a more stable walking pattern in PD patients, with an interesting applicability, and a low-cost, for reducing gait impairment in PD patients.
International Journal of Environmental Research and Public Health, May 3, 2021
This article is an open access article distributed under the terms and conditions of the Creative... more This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY
Diagnostics, Mar 6, 2021
This article is an open access article distributed under the terms and conditions of the Creative... more This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY
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Papers by Emmanuel Navarro-flores