Dr. Ulloa-Díaz, David

Background and Objectives: Osteoarthritis (OA) of the knee and hip is a major cause of pain and functional impairment. This study evaluated the effects of non-immersive virtual reality (NIVR) combined with conventional physical therapy (CPT) on pain intensity, mechanical hyperalgesia, and perceived recovery in older adults with OA. Materials and Methods: Sixty older adults with mild-to-moderate knee or hip OA were randomly assigned to a NIVR group (NIVR-G; n = 30) or a CPT group (CPT-G; n = 30). Both groups completed 30 sessions over 10 weeks (3 sessions/week). The NIVR-G performed 20 minutes of exergames integrated into CPT. Pain intensity was assessed using the Visual Analog Scale (VAS), and mechanical hyperalgesia was evaluated through pressure pain thresholds (PPTs). Secondary outcomes included the Global Rating of Change (GRoC) and the minimal clinically important difference (MCID) for the VAS. This study is a secondary analysis of a randomized controlled trial registered at ClinicalTrials.gov (ID: NCT05839262). Results: The NIVR-G demonstrated significant reductions in pain intensity after 30 sessions (p < 0.05, d = 1.50), with greater improvements compared to the CPT-G (p < 0.05, d = 1.17). The MCID for the VAS was established at 9.2 mm, with a higher proportion of responders in the NIVR-G (p < 0.05). The NIVR-G also reported superior recovery perception on the GRoC scale (p < 0.05). No significant changes in PPTs were observed in either group. However, the improvements in the NIVR-G diminished four weeks post-intervention. Conclusions: NIVR exergames combined with CPT significantly reduced pain intensity, improved perceived recovery, and resulted in a higher proportion of responders compared to CPT alone. These findings support the use of NIVR as an effective adjunct to CPT in older adults with OA; however, further research is needed to optimize its long-term benefits.

Fibromyalgia (FM) is characterized by persistent widespread pain that severely impacts quality of life. Immersive virtual reality-based exercise (iVRE) is emerging as a therapeutic modality for chronic pain management. However, research on iVRE in FM patients has primarily focused on perceived pain intensity (PI), with limited exploration of underlying analgesic mechanisms. This study aims to explore the effects of iVRE on PI, considering risk of poor outcomes (RPO) stratification, and on mechanical pain sensitivity (MPS) in FM. A single-arm, uncontrolled, pre-post-test exploratory study was conducted in subjects with FM. The intervention included 2 weekly 15-min iVRE sessions for 6 weeks. PI (numeric rating scale [NRS]) and MPS (pressure pain thresholds [PPTs] at the upper trapezius, lumbar spine, and knee) were assessed at baseline, after the first session (to assess exercise-induced hypoalgesia), and postintervention. RPO was assessed using the Keele STarT MSK Tool. Eleven participants completed the study. No adverse effects were reported. Clinically important reductions were observed in PI (mean difference [MD]: −2.36, 95% CI: [−4.15, −0.58], d = 0.89; p < 0.05) with this effect being associated with baseline RPO. No observable changes were found in PPTs (all 95% CIs included 0, p > 0.05). In this sample, iVRE appears to reduce PI but not PPTs, suggesting the persistence of MPS and limitations in activating endogenous pain inhibitory mechanisms. Further randomized controlled trials with larger samples are needed to corroborate these results.

Background/Objectives: Osteoarthritis (OA) is a leading cause of mobility impairment in older adults, yet few studies have explored exergames (EXGs) as a complementary therapy for knee and/or hip OA (KOA/HOA). This study evaluated the effects of integrating EXGs into conventional therapy (CT) on functional mobility. Methods: Sixty participants were randomized into an EXG/CT group or a CT-only group. The interventions lasted 10 weeks (3 sessions/week), and the EXGs were selected from the interactive game Ring Fit Adventure (Nintendo Switch®, Kyoto, Japan). Results: Functional mobility (Timed Up and Go test) significantly improved in the EXG/CT group but not in the CT group. Additionally, lower-limb strength and aerobic endurance increased in the EXG/CT group. No adverse events were reported, and the adherence was high. Conclusions: These findings support EXG-based interventions as a viable complement to CT. Future studies should design OA-specific EXGs and include patient subgroups to expand the impact of interventions using virtual systems.

Background: This study aimed to explore whether a predictive model based on body composition and physical condition could estimate seasonal playing time in professional soccer players. Methods: 24 professional soccer players with 5–7 years of professional experience participated. Body composition and physical condition variables were assessed, and total minutes played during the season were recorded as the dependent variable. Correlations between variables were examined to reduce multicollinearity, followed by a principal component analysis (PCA) of the selected predictors. The first three components were used as inputs in a Gradient Boosting model. Model performance was evaluated using 5-fold cross-validation and leave-one-out cross-validation (LOOCV). Results: High intercorrelations among independent variables (r > 0.70) justified dimensionality reduction through PCA. The first three components explained 70% of the total variance. However, no direct correlations were observed between individual variables and minutes played, and the Gradient Boosting model did not achieve positive predictive performance under cross-validation (5-fold CV: R2 = −0.04; LOOCV: R2 < 0). Conclusion: In this small dataset, a multivariate approach combining PCA and Gradient Boosting did not yield predictive accuracy for playing time. Nonetheless, the PCA revealed meaningful structures in the players’ physical and body composition profiles, which may inform future research. Larger and more heterogeneous samples are required to determine whether component-based predictors can reliably estimate playing time in professional soccer.

Background: The aim of our study was analyze the bilateral strength balance of the knee extensor and flexor muscles in female soccer players. Methodology: Participated in this study twenty-three professional female soccer players. The volunteer participants of the study were eligibly if: (a) signing of informed consent, (b) 5 years of sporting experience as a soccer player and have experience with training and evaluation of muscle strength in the lower limb, (c) participate in five weekly training sessions (d) no musculoskeletal pathology in the lower limbs 6 months prior to the evaluation date. The assessment was performed unilaterally, with peak muscle strength values recorded using the FEMD device software at a constant velocity of 0.4 m s-1. The range of motion (ROM) was 90°–0° of joint extension in the sitting position and 150°–90° of flexion in the prone position. Each participant was required to perform their maximum effort for all repetitions. Results: Bilateral strength balance measurements were obtained in the range of 10.68%–13.80% for maximum muscle strength in knee extension and 13.27%–15.21%. No significant differences (p > 0.05) were found in the comparison of independent means for maximum muscle strength between the knee extension and flexion in the concentric and eccentric phases. Significant differences (p < 0.01) and small ES (ES < 3.32) were found in peak muscle strength measurements of the dominant and non-dominant lower extremity in the unilateral comparison of the extensor muscle and the flexor muscle group in the concentric and eccentric phase. Conclusion: In the analysis of bilateral strength balance, lower indices are presented in the knee extensor compared to the flexor, these bilateral indices would reveal intrinsic and extrinsic risk factors for musculoskeletal injuries in the hamstring muscles and anterior cruciate ligament of professional soccer players.

Objective: This systematic review and meta-analysis aimed to (I) evaluate the evidence on the effects of high-intensity interval training (HIIT) on systolic blood pressure (SBP) and diastolic blood pressure (DBP) in hypertensive patients; (II) determine whether HIIT impacts SBP and DBP differently; and (III) assess the clinical relevance of these effects. Methods: A comprehensive search was conducted across multiple electronic databases, resulting in the inclusion of seven randomized clinical trials in the meta-analysis. The outcomes were analyzed using random-effects models to compute mean differences (MD) and standardized mean differences (SMD) for SBP and DBP. Results: A small reduction in SBP was observed with HIIT interventions (MD −3.00; 95% CI −4.61 to −1.39; p < 0.0001; SMD −0.28; 95% CI −0.42 to −0.13; p = 0.0003). However, no statistically significant reductions were detected for DBP (MD −0.70; 95% CI −1.80 to 0.39; p = 0.21; SMD −0.07; 95% CI −0.22 to 0.08; p = 0.35). Despite demonstrating statistical significance for SBP, the effects did not reach clinical relevance. Conclusions: HIIT interventions yield small reductions in SBP, with minimal impact on DBP. These findings suggest limited clinical relevance in the management of hypertension. Further randomized controlled trials are necessary to standardize HIIT protocols, with specific emphasis on intensity control and manipulation, to better understand their potential role in hypertensive populations.