Supraspinatus tendinopathy is one of the most common causes of shoulder pain. Many studies support conservative treatments such as exercise, trigger point dry needling or corticosteroid injections. Otherwise, a minimally invasive approach with percutaneous electrolysis (PE) has also been used successfully in shoulder pain, although evidence about its long-term effects is scarce. The aim of this trial was to determine the effects of PE on supraspinatus tendinopathy compared with trigger point dry needling (TDN). Thirty-six patients with supraspinatus tendinopathy were randomly assigned to either a PE group (n = 18) or a TDN group (n = 18). Both groups also performed eccentric exercises. The main outcome to be measured was the Numerical Pain Rating Scale (NPRS), but the shoulder range of motion (ROM) and trigger point pressure pain threshold (PPT) were also considered. A one-year follow-up was conducted. Significant differences favoring the PE group were found regarding pain at one-year follow-up (p = 0.002). The improvement achieved in the PE group was greater in the NPRS (p < 0.001), proximal PPT, middle PPT, distal PPT (all p < 0.001) and ranges of movement. PE seems to be more effective than TDN in relieving pain and improving ROM and PPT supraspinatus values in patients with supraspinatus tendinopathy, both right after treatment and at one-year follow-up.

Few studies have considered the effects of percutaneous electrolysis (PE) in the treatment of lateral epicondylalgia (LE). For this reason, the objective of this study was to compare the effects of PE with an evidence-based approach—trigger point dry needling (TDN)—in patients with LE. A randomized controlled trial was conducted in which 32 participants with LE were randomly assigned to two treatment groups, the PE group (n = 16) and the TDN group (n = 16). Both groups received four therapy sessions and an eccentric exercise program to be performed daily. The numerical pain rating scale (NPRS), pressure pain thresholds (PPT), quality of life, and range of motion were measured before treatment, at the end of treatment, and at one- and three-month follow-ups. Significant between-group mean differences were found after treatment for NPRS (p < 0.001) and flexion movement (p = 0.006). At one-month follow-up, significant mean differences between groups were found for NPRS (p < 0.001), PPT (p = 0.021), and flexion (p = 0.036). At three-months follow-up, significant mean differences between groups were found for NPRS (p < 0.001), PPT (p = 0.004), and flexion (p = 0.003). This study provides evidence that PE could be more effective than TDN for short- and medium-term improvement of pain and PPTs in LE when added to an eccentric exercise program.

Patients with fibromyalgia syndrome (FMS) have a nonspecific postural balance disorder and a greater prevalence of falls. Objective: to clarify which aspects of maintaining balance are associated with the impact of the disorder and with balance confidence. Methods: A total of 182 persons with FMS agreed to participate in this study. After re-evaluation, 57 fully met inclusion criteria: age 40–70 years and moderate-severe impact of the illness according to the Fibromyalgia Impact Questionnaire (FIQ). All participants underwent a posture control analysis with a stabilometric platform, an evaluation of the perception of verticality and an exploration of the vestibular system via functional tests. Additionally, they self-completed questionnaires about balance confidence, central sensitization, pain catastrophizing, kinesiophobia, dizziness and days with episodes of instability. Results: The FIQ was associated with central sensitization and dizziness, which explained 56% of its variance (AdjR2 = 0.566), while days with instability, kinesiophobia and dizziness also explained more than half of the variance of the balance confidence scale (AdjR2 = 0.527). A high percentage of positive responses was found for functional tests (>50%) and a high dispersion in the stabilometric parameters. Conclusion: the detection of factors susceptible to intervention, such as disability due to dizziness, takes on special relevance in patients with FMS.

Background: The Migraine Disability Assessment (MIDAS) questionnaire is widely used to determine the degree of migraine-related disability of subjects. So far, and to the best of our knowledge, no Spanish version of this tool has been validated. The questionnaire comprises seven items, with the first five constituting the main scale while the sixth and seventh items referring, respectively, to the frequency and intensity of headache. The present study aims to analyze the clinimetric properties of the Spanish version of the MIDAS questionnaire in a population of university students. Methods: We performed a cross-sectional study of validation for this measuring instrument. A total of 153 subjects participated in the study. We analyzed construct validity using factor analysis, test-retest reliability by the Intraclass Correlation Coeficient (ICC), internal consistency, and concurrent validity with respect to the 12-Item Short Form Health Survey (SF-12). Results: Factor analysis revealed a two-factor structure. The questionnaire has good reliability for the MIDAS mainscale score ([ICC = 0.81; 95% CI: 0.63-0.90]), excellent reliability for headache frequency (ICC = 0.90; 95%; CI: [0.79-0.95]), and moderately good reliability for headache intensity (ICC = 0.63; 95% CI: [0.34-0.80]). The analysis also yielded good internal consistency results (α Cronbach = 0.797) and a moderate correlation between MIDAS-main scale and the physical component summary of SF-12 (Rho = − 0.326; p < 0.001). Conclusions: The Spanish version of the MIDAS questionnaire is a valid and reliable tool to measure migrainerelated disability in university subjects. The two additional items provide information that could help clinicians in making decisions.

BACKGROUND:The interpretation of the verticality of the environment is crucial for a proper body balance. The subjective visual vertical test (SVV) is a widely used method to determine the visual perception of the verticality, whose alteration has been related with poor functional status. OBJECTIVE: To analyze the visual perception of the verticality in neurological patients in comparison with healthy controls. METHODS: We searched PubMed, Scopus, and Scielo from the start of the databases until October 2017 and manually searched the reference lists of studies comparing SVV values between neurological patients and controls. Standardized mean difference (SMD) and subgroup analysis were used to analyze differences between neurological patients and healthy subjects and between stroke and non-stroke patients, respectively. RESULTS: A total of 1,916 subjects from 31 studies were included. Neurological patients misestimate the true vertical in comparison with controls (SMD = 1.05; 95% CI: 0.81, 1.28). The misperception of the verticality was higher in stroke patients (SMD = 1.35; 95% CI: 1.02, 1.68) than in patients with other neurological conditions (SMD = 0.48; 95% CI: 0.29, 0.68). CONCLUSIONS: Neurological patients showed a misperception of the verticality, estimated using the SVV. The neurological pathology that most alters the SVV is stroke.