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.

The peak velocity of an athlete’s throws is a determining factor for sports performance. The aim of this study was to analyze the effects of a post-activation performance enhancement (PAPE) protocol with functional electro-mechanical dynamometry (FEMD) on throwing velocity. Thirteen international-level female handball players voluntarily participated in the study. The PAPE protocol considered four sets of eight repetitions controlled by FEMD (four at 30% of 1RM followed by another four at 60% of 1RM). After each series, the athletes’ throwing velocity was measured. Significant differences (p < 0.01) were found in the effect size (ES), which measures the strength of the statistical relationship between two variables by group with the repeated measures ANOVA statistic with an effect size ω2 = 0.028. The effect size analysis identified measurements that are considered null for the baseline—PAPE 1 comparison and small baseline—PAPE 2, baseline—PAPE 3, and baseline—PAPE 4. When resistance is controlled during the run as with an FEMD device, only two sets of eight repetitions (four repetitions at 30% and four repetitions at 60% of 1RM) are required for the improvement of throwing speed in elite handball players.

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.

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.

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.

Background: The Chilean population has experienced increased longevity in recent decades, leading to an increased incidence of and mortality from neurodegenerative diseases such as Parkinson’s disease (PD). PD is a chronic degenerative condition that affects the central nervous system. The main objective of this research is to evaluate the effect of 12-week programs of tonic, isometric, and isometric/vibratory muscular strength training while controlling the manipulation of the intensity variable on motor and non-motor symptomatology in PD patients. The secondary objective is to assess the levels of muscular strength in PD patients and their relationship with motor and non-motor symptomatology. Methods: A parallel-group, randomized trial will randomly assign (n = 34) people of both sexes with Parkinson’s disease between stages I–III Hoehn and Yahr (H&Y), aged between 50 and 70 years to one of the experimental groups, in which they will undergo a total of 24 strength training sessions during 12 weeks. During the intervention period, the participants will be advised not to undertake additional exercise programs, to avoid substances that may disrupt metabolism and circadian cycles, and to maintain their medication regimen. The primary or motor evaluation of rest tremor will be performed with an accelerometer (Actigraphy), balance with the Mini-BESTest balance test, gait speed with the Ten Meters Walk Test, and non-motor symptomatology through anxiety, depression (MDS-UPDRS), and quality of life (PDQ-39) questionnaires. The Secondary evaluation of muscle strength will be performed with a functional electromechanical dynamometer. Discussion: Established as a hypothesis is that manipulating intensity variables in 12-week tonic, isometric, and isometric/vibratory muscle strength training programs has an effect on motor and non-motor symptomatology in people with Parkinson’s disease. The research will establish the extent to which controlled muscular strength training has an effect on relevant factors related to motor and non-motor symptomatology.

The purpose of the study was to analyze the test–retest reliability of an isometric and isometric/vibratory muscular strength protocol in the bilateral seated bench press (BSBP), bilateral seated rowing (BSR), unilateral seated right knee extension (USKER), and left knee extension (USKEL) tests controlled using functional electromechanical dynamometry (FEMD) in healthy young adults. A repeated measures design was used to determine the reliability of a muscular strength protocol in isometric and isometric vibration modes with FEMD. No significant differences were found in test–retest analysis (p > 0.05; ES < 0.20); and high reliability (CV = 4.65–5.02%; ICC = 0.99–0.98) was found for BSBP measures, and acceptable reliability (CV = 3.71–9.61%; ICC = 0.98–0.95) was found for BSR, USKER, and USKEL. Furthermore, the coefficients between the two measures were strong (r = 0.963–0.839) and highly significant (p = 0.001) for maximal strength in the isometric and maximal isometric/vibratory assessment of muscle strength in all muscle strength tests. This study demonstrates that isometric and maximal isometric/vibratory strength in the BSBP, BSR, USKER, and USKEL tests can be measured with high reliability and reproducibility using the FEMD.

Background: Systematizing reliable protocols and procedures for strength assessment in handball has allowed for a more thorough kinetic analysis and increased precision in detecting training-induced changes in muscular strength. The evaluation of upper limb strength with a bilateral standing press (BSP) exercise in handball players approximates blocking actions in the defensive phase, pushing and fixation. Aim: The aim of this study was to analyze the relative and absolute reliability of intra-session comparisons in an isometric peak muscle strength protocol in a bilateral standing press (BSP) exercise among female handball players. Methods: Sixteen young female handball players at an international level, aged between 22 ± 4 years, with no prior experience in using functional electromechanical dynamometers (FEMD) participated in this study. The participants initiated the assessment of maximum isometric force in a bipedal stance with a forward projection of the dominant foot between 20 and 30 cm. The knees were kept semi-flexed, and the hip extension of the non-dominant limb ranged from 15 to 20°. Bilateral anterior push of the upper limb was performed with shoulder abduction and elbow flexion at 90°, maintaining a pronated hand position. Participants were instructed to exert three sets of maximal force for 5 s in BSP exercise. Relative reliability was assessed using the model intraclass correlation (ICC) and absolute reliability was assessed using the coefficient of variation (CV) and standard error of measurement (SEM). For this study, the parameters of maximum and mean muscle strength were considered. Results: The results demonstrated high relative reliability (ICC 0.93–0.97) and absolute reliability (SEM 0.19–2.79) y (CV 4.78–9.03) for both mean force and peak force, with no significant differences between the sets (p > 0.05), indicating a negligible effect size (0.01−0.12). Conclusion: The mean and peak isometric muscle strength for the BSP exercise controlled with FEMD in female handball players exhibits high relative and absolute reliability between series.

Aumentar los niveles de actividad física (AF) tiene múltiples beneficios a lo largo de todo el ciclo de vital. Durante la infancia y la adolescencia se deben afianzar los hábitos de vida activa en niños y jóvenes para mantener o mejorar su bienestar físico, mental y el estado de salud actual y futuro. A fines de abril de 2020, aproximadamente 1.500 millones de niños y adolescentes, iniciaron su proceso de enseñanza-aprendizaje a distancia, debido al cierre de las escuelas en la mayoría de los países. El objetivo de este estudio fue analizar el nivel de AF de adolescentes de la comuna de Concepción después del periodo de confinamiento por COVID-19. Un total de 381 estudiantes de ambos sexos (203 hombres y 178 mujeres), entre 14 a 16 años de establecimientos educacionales secundarios participaron del estudio. Los resultados demostraron que los adolescentes presentan un nivel de AF clasificado como inactivos (PAQ-A = 2.53 puntos), los hombres presentan una diferencia significativa (p = .001) en comparación con el grupo de mujeres en el nivel de AF, se observa una diferencia significativa entre las distintas edades de los hombres (p = .027) y de las mujeres (p = .001), además, se observó una diferencia significativa entre los establecimientos educacionales (p = .012). La vuelta a la presencialidad y las estrategias implementadas para un mayor desarrollo de la AF después del periodo de confinamiento, obtuvieron un nivel bajo de AF de los estudiantes de educación secundaria en establecimientos educacionales particular subvencionado de la comuna de Concepción.

La percepción de la clase de educación física por parte de los estudiantes es un factor importante porque dependiendo de cómo los escolares perciban estas vivencias, se generarán determinadas creencias o valoraciones, las que influyen en la actitud para enfrentar estas experiencias corporales cada vez que se presenten. 176 estudiantes (14.74 ± 0.68), pertenecientes a los establecimientos particulares subvencionados de la comuna de Coronel. El objetivo de esta investigación es analizar la percepción actitudinal subjetiva de los estudiantes de enseñanza secundaria hacia los profesores de EF. Para evaluar la percepción actitudinal de los estudiantes hacia el profesor de educación física, se utilizó una modificación del cuestionario de actitudes de los escolares hacia la educación física. En los resultados de la actitudes positivas, se puede indicar que el alumnado valoro mayormente el ítem “Muy de acuerdo” en la pregunta “Mi profesor/a de educación física sabe mucho”, en las actitudes negativas la pregunta “Mi profesor/a de educación física levanta la voz frecuentemente” fue el mayor porcentaje en el ítem “Muy de acuerdo” . En el análisis comparativo entre hombres y mujeres para la percepción positiva reporto (p = 0.63) y negativa (p = 0.10). En el análisis por edades para la escala positiva (p = 0.01), para la escala negativa (p = 0.25). El alumnado observo mayormente actitudes positivas de y muy pocas negativas en el profesor de educación física, sin observase diferencias entre hombres y mujeres, en las edades se reportaron diferencias en las actitudes positivas y negativas del profesor, informando que los alumnos de con más edad evalúan más críticamente las actitudes positivas y negativas del profesor de EF.