BACKGROUND: Fibromyalgia is a chronic condition characterized by generalized pain. Several studies have been conducted to assess the effects of non-pharmacological conservative therapies in fibromyalgia. OBJECTIVE: To systematically review the effects of non-pharmacological conservative therapies in fibromyalgia patients. METHODS: We searched MEDLINE, Cochrane library, Scopus and PEDro databases for randomized clinical trials related to non-pharmacological conservative therapies in adults with fibromyalgia. The PEDro scale was used for the methodological quality assessment. High-quality trials with a minimum score of 7 out of 10 were included. Outcome measures were pain intensity, pressure pain threshold, physical function, disability, sleep, fatigue and psychological distress. RESULTS: Forty-six studies met the inclusion criteria. There was strong evidence about the next aspects. Combined exercise, aquatic exercise and other active therapies improved pain intensity, disability and physical function in the short term. Multimodal therapies reduced pain intensity in the short term, as well as disability in the short, medium and long term. Manual therapy, needling therapies and patient education provided benefits in the short term. CONCLUSIONS: Strong evidence showed positive effects of non-pharmacological conservative therapies in the short term in fibromyalgia patients. Multimodal conservative therapies also could provide benefits in the medium and long term.

BACKGROUND: The detection of primary risk factors through the assessment of shoulder range of motion (ROM) and muscle function could prevent injuries in the initial stages of the handball (HB) practice. OBJECTIVE: To compare shoulder ROM, muscle strength and muscle extensibility between throwing and non-throwing shoulders in young HB athletes and between non-HB athletes. METHODS: A cross-sectional study was designed. Participants aged between 14–16 years that practice physical activity regularly were included and divided in two groups. The HB group included volunteers who practiced HB, the control group included volunteers who practiced other activities. The variables measured were internal rotation and external rotation ROM, maximum isometric strength, and extensibility of the tissues of the posterior part of the throwing and non-throwing shoulder. RESULTS: Thirty-seven subjects were included. The HB group (n= 19) showed greater ROM in both shoulders compared to the control group (n= 18) (p< 0.05). The throwing shoulder of the HB group showed less internal rotation ROM, greater external rotation ROM and greater internal rotation strength when compared to the non-throwing shoulder (p< 0.05). CONCLUSIONS: The results of the study suggest that young HB athletes present differences in shoulder ROM compared to non-HB athletes. Also, HB athletes showed differences in ROM and strength between the TS and non-TS. Hence, the assessment of the shoulder ROM and muscle function should be taken into consideration to avoid injuries in this population.

Efectos ergonómicos inmediatos de un apoyo isquiático en la sedestación. Herramienta preventiva para la información en salud ResumenIntroducción: La información sobre la correcta ergonomía se ha incrementado para disminuir la prevalencia de síntomas lumbares y/o cervicales en la población. Sin embargo, el acondicionamiento y el mobiliario de las instituciones universitarias no se adecuan a las características individuales de los sujetos, lo cual dificulta el proceso. Objetivo: analizar los cambios en la postura, al incorporar un apoyo isquiático en sujetos jóvenes. Material: Estudio transversal comparativo sobre 76 sujetos universitarios voluntarios (24 varones y 52 mujeres, edad media de 20,7; DT ± 2,64). Se registró la postura mediante fotogrametría sagital con un software 2D, en posición de sedestación y en sedestación corregida mediante la colocación de un apoyo isquiático de 5 centímetros de altura. Posteriormente se analizaron los ángulos cráneo-vertebral (CV), cervical superior (CS), cervical inferior (CI), lumbar (AL). Resultados: Se encontraron diferencias estadísticamente significativas entre la posición sedente y la sedente corregida en todos los ángulos analizados (p<0,01). Consiguiendo la disminución de la flexión lumbar y de la posición de cabeza adelantada. Conclusión: La utilización de un apoyo isquiático de 5 centímetros de altura en la posición de sedestación, disminuye la flexión lumbar y la posición de cabeza adelantada en comparación con una sedestación sin apoyo en sujetos jóvenes. Palabras clave: postura; columna; comunicación; ingeniería humana; educación para la salud AbstractIntroduction: Information about correct ergonomics is increasing in order to avoid cervical and lumbar symptoms. However, the furniture of the colleges does not fit the individual characteristics, which make difficult the process. Objective: Analyse the posture change, when an ischial support is incorporated in young population. Methods: Cross sectional study. 76 volunteers students were included (24 men and 53 women, average age 20,7 SD ± 2,64). Posture was registered with sagittal photogrammetry and analysed by 2D software, in sitting position and corrected sitting position by 5-centimeters-isquial-support. Then, Neck Slope angle (NS), Upper Cervical angle (UP) Lower cervical angle (LC) and lumbar spine angle (LS) were analysed. Results: Statistical differences were found between the sitting position and corrected sitting position in all analysed angles (p<0,01). This means less lumbar flexion and forward head position. Conclusion: A 5-centimeter-isquial-support decrease lumbar flexion and forward head position compared to sitting position without ischial support in young adults.