Departamento de Ciencias de la Salud

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Associations between the impact of menopausal symptoms and fall-related self-efficacy
(Lippincott, 2023-04-01) Espírito-Santo, João; Marques de Loureiro, Nuno Eduardo; Brandão Loureiro, Vânia; Aibar-Almazán, Agustín; Hita-Contreras, Fidel
Objective: To analyze the association between the severity of menopausal symptoms and two important fall risk factors, namely balance confidence and fear of falling, among Portuguese and Spanish postmenopausal women aged ≥ 65 years. Methods: A cross-sectional, observational study was conducted on 363 women (66.21 ± 9.00 years) from several Portuguese and Spanish locations. The Menopause Rating Scale (MRS) was used to evaluate the severity of menopausal symptoms, while the Falls Efficacy Scale-International and Activities-specific Balance Confidence Scale-16 items were used to assess balance confidence and fear of falling, respectively. Anxiety and depression (evaluated by the Hospital Anxiety and Depression Scale), age, time since the onset of menopause, body mass index (BMI), history of falls, osteoporosis, smoking habit, physical activity level, and nocturia were considered as potential confounders. Independent associations were analyzed after adjusting for potential confounding variables. Student’s t test, bivariate correlations and multivariate linear regression analysis were performed. Results: A total of 363 women (66.21 ± 9.00 years) participated in the study, 192 from Portugal and 171 from Spain. Linear regression analysis indicates that more severe menopausal symptoms at a somato-vegetative level (beta coefficient (β) = -0.25; 95% confidence interval (95% CI):-2.09 to -0.81; p = <0.001), a higher BMI (β = -0.16; 95% CI:-1.22 to -0.22; p = 0.005), and osteoporosis (β = 0.14; 95% CI: 1.36 to 10.08; p = 0.010) were associated with lower balance confidence values. On the other hand, a higher score in the MRS somato-vegetative domain (β = 0.22; 95% CI: 0.27 to 0.79; p = <0.001), depression (β = 0.36; 95% CI: 0.59 to 1.08; p = <0.001), and years after the menopause onset (β = 0.15; 95% CI: 0.04 to 0.22; p = 0.006) were linked to increased fear of falling. Conclusions: The findings of our study show that, after taking into account possible confounders, increased severity of menopausal symptoms at a somatic level was associated with heightened fear of falling and diminished balance confidence.
Associations of sleep and depression with obesity and sarcopenia in middle-aged and older adults
(ELSEVIER IRELAND LTD, 2020-12) Fábrega-Cuadros, Raquel; Cruz-Díaz, David; Martínez-Amat, Antonio; Aibar-Almazán, Agustín; Redecillas-Peiró, María Teresa; Contreras-Hita, Fidel
Objectives: To analyze the association of depression and the quality and duration of sleep with general and abdominal obesity, sarcopenia, and sarcopenic obesity (SO) in Spanish middle-aged and older adults. Study design and outcome measures: A total of 304 participants (72.04±7.88 years, 83.88% women) participated in this study. Body mass index, waist circumference, skeletal muscle mass index (bioelectrical impedance analysis), and hand-grip strength were used to evaluate sarcopenia, obesity, and SO. The Pittsburgh Sleep quality index was used for sleep quality. Sleep duration (hours) was categorized as either short (<6), normal (6-8), or long (>8). Depression was measured using the Hospital Anxiety and Depression Scale. Fatigue (Fatigue Severity Scale), nutritional status (Mini Nutritional Assessment survey) and physical activity (PA) level (International Physical Activity Questionnaire-Short Form) were also assessed. Independent associations were evaluated by multivariate logistic regressions. Results: Only depression was associated with sarcopenia (OR=1.10, 95% CI=1.02-1.19). Poorer sleep quality (OR=1.06, 95% CI=1.06-1.11) and short sleep duration (OR=2.63, 95% CI=1.45-4.78) were related to general obesity, as well as fatigue and low PA level. Poor sleep latency (OR=1.43, 95% CI=1.09-1.87) was linked to abdominal obesity, along with fatigue, low PA level, older age, and female sex. Finally, short sleep duration (OR=5.25, 95% CI=1.97-14.00), together with fatigue, low PA level, and male sex were associated with OS. Conclusion: Among Spanish middle-aged and older adults, after adjusting for potential confounding variables, depression was uniquely associated with sarcopenia, while short sleep duration was related to general and sarcopenic obesity, and poor sleep quality was linked to general and abdominal obesity.
Does participation in therapeutic exercise programs after finishing oncology treatment still ensure an adequate health status for long-term breast cancer survivors? A ≥ 5 years follow-up study
(SPRINGER, 2023-05-18) Álvarez-Salvago, Francisco; Jiménez-García, José Daniel; Pujol-Fuentes, Clara; Atienzar-Aroca, Sandra; Molina-García, Cristina; Aibar-Almazán, Agustín
Purpose: The aims of this study were to evaluate whether the effects of two therapeutic exercise programs are sustained over time (≥ 5 years) in long-term breast cancer survivors (LTBCS). Second, to determine the influence of the current level of physical activity (PA) performed on cancer-related fatigue (CRF) that these patients may present ≥5 years later. Methods: A prospective observational study was conducted with a cohort of 80 LTBCS in Granada during 2018. Firstly, considering their participation in one of the programs, they were allocated into two groups: usual care and therapeutic exercise program, to assess CRF, pain and pressure pain sensitivity, muscle strength, functional capacity, and quality of life. Secondly, they were also classified into 3 groups according to current level of weekly PA performed: ≤ 3, 3.1-7.4, and ≥ 7.5 (MET-hour/week) respectively, to assess its impact over CRF. Results: Although the positive effects of the programs are not sustained over time, a trend toward significance can be observed for a greater reduction in overall CRF levels, lower intensity of pain in the affected arm and cervical region, and greater functional capacity and quality of life in the group that underwent therapeutic exercise. Additionally, 66.25% of LTBCS are inactive ≥ 5 years after completion of the program and furthermore, such inactivity is accompanied by higher CRF levels (P .013 to .046). Conclusion: The positive effects of therapeutic exercise programs are not maintained over time for LTBCS. Additionally, more than half of these women (66.25%) are inactive ≥ 5 years after completion of the program, this inactivity being accompanied by higher levels of CRF.
Effect of combined physical–cognitive training on the functional and cognitive capacity of older people with mild cognitive impairment: a randomized controlled trial
(BMC, 2024-07-08) Castellote-Caballero, Yolanda; Carcelén-Fraile, María del Carmen; Aibar-Almazán, Agustín; Afanador-Restrepo, Diego; González-Martín, Ana María
Background: The increase in population aging highlights the growing prevalence of mild cognitive impairment, prompting the adoption of interventions that combine physical exercise and cognitive training to improve health and cognitive performance in older adults. The aim of this study was to analyze the efficacy of a combined program on physical and cognitive health in older people with cognitive impairment. Methods: A 12-week randomized controlled clinical trial involving 95 participants (aged 72.12 ± 4.25 years), 47 individuals participated in a control group (CG) that only underwent cognitive stimulation, while 48 individuals were in an experimental group (EG) that participated in a combined program. Balance was measured using the Tinetti scale, upper body strength was assessed with the arm curl test, lower body strength was evaluated with the 30-s chair stand test, flexibility was tested using the back scratch test and chair sit-and-reach test, physical function was measured with the Timed Up and Go test, cognitive function was assessed using the Mini Mental State Examination, cognitive impairment was evaluated with the Montreal Cognitive Assessment, verbal fluency was tested with the Isaac test, and executive functions were assessed using the Trail Making Test. Results: The results of the study show significant improvements in both physical and cognitive aspects, such as balance, gait, upper and lower body strength, flexibility, physical function, cognitive function, cognitive impairment, verbal fluency, and executive functions in the group that carried out the intervention compared to the control group. Conclusion: A combined program for older individuals with mild cognitive impairment leads to enhancements in physical and cognitive health. These improvements underscore the importance of integrating physical exercise with cognitive training as an effective strategy for enhancing overall health and quality of life in older adults.
Effectiveness of Therapeutic Education in Patients with Cancer Pain: Systematic Review and Meta-Analysis
(MDPI, 2023-07-10) González-Martín, Ana María; Aguilera-García, Iván; Castellote-Caballero, Yolanda; Rivas, Yulieth; Bernal-Suárez, Antonio; Aibar-Almazán, Agustín
Objective: To review the existing evidence on pain education in patients with pain derived from an oncological process. Methods: A systematic review was conducted using the databases Pubmed, Web of Science, PEDro, and Scopus. The selected studies had to incorporate instruction about the neurophysiology of pain into their educational program. The target population was cancer patients who had suffered pain for at least one month. The methodological quality of the articles collected was assessed using the PEDro scale. Results: Some 698 studies were initially identified, of which 12 were included in this review. Four different models of pain education programs were found in the studies’ interventions. Pain intensity, pain experience, quality of life, pain tolerance, and catastrophism were the variables that appeared most frequently. Conclusions: This review demonstrates that pain education in patients with cancer pain may produce effects such as decreased pain intensity and catastrophism. Knowledge about pain also seems to increase. However, no benefit was reported for patients’ overall quality of life. Therefore, more research is needed to clarify the effects of these interventions on the oncology population.
Effects of a Yoga Program Combined with a Mediterranean Diet on Nutritional Status and Functional Capacity in Community-Dwelling Older Adults: A Randomized Controlled Clinical Trial
(MDPI, 2024-04-24) Carcelén-Fraile, María del C.; Martín-Baute, María R.; Ledesma-Cerrato, María I.; Castellote-Caballero, Yolanda; González-Martín, Ana M.; Hita-Contreras, Fidel; Cano-Sánchez, Javier; Aibar-Almazán, Agustín
Background: With the aging population, effective interventions are needed to enhance the health of older adults. This study investigated the combined effects of yoga and the Mediterranean diet on various health outcomes in community-dwelling older adults. Methods: The study employed a randomized controlled trial design with a total of 116 older adults randomized to an experimental group (n = 57) that underwent a combined yoga and Mediterranean diet program and a control group (n = 59) that did not receive any intervention. Nutritional status was assessed using the Mini Nutritional Assessment, flexibility with the Back Scratch Test and the Chair Sit-and-Reach Test, balance, gait, and fall risk with the Tinetti Scale, and muscle strength with a dynamometer and the 30 s Chair Stand Test. Results: Regarding nutritional status, there were significant differences between the experimental group and the control group (Cohen’s d = 0.02). The participants in the experimental group showed greater balance (11.12 ± 3.01 vs. 10.03 ± 2.35, Cohen’s d = 0.41 and gait (7.63 ± 1.96 vs. 6.69 ± 2.50, Cohen’s d = 0.44) with respect to the control group. In terms of flexibility, the experimental group showed statistically significant improvements in the right arm (Cohen’s d = 0.43), left arm (Cohen’s d = 0.64), right perineum (Cohen’s d = 0.42), and left leg (Cohen’s d = 0.37) Finally, in terms of strength, participants in the experimental group experienced statistically significant improvements in grip strength and lower body strength (Cohen’s d = 0.39 and 0.81, respectively). Conclusions: The study highlights the potential benefits of a 12-week intervention combining yoga with a Mediterranean diet to improve the health and functional capacities of community-dwelling older adults.
Impact of Psychological Distress and Sleep Quality on Balance Confidence, Muscle Strength, and Functional Balance in Community-Dwelling Middle-Aged and Older People
(MDPI, 2020-09-22) Fábrega-Cuadros, Raquel; Aibar-Almazán, Agustín; Martínez-Amat, Antonio; Hita-Contreras, Fidel
The objective was to evaluate the associations of psychological distress and sleep quality with balance confidence, muscle strength, and functional balance among community-dwelling middle-aged and older people. An analytical cross-sectional study was conducted (n = 304). Balance confidence (Activities-specific Balance Confidence scale, ABC), muscle strength (hand grip dynamometer), and functional balance (Timed Up-and-Go test) were assessed. Psychological distress and sleep quality were evaluated by the Hospital Anxiety and Depression Scale and the Pittsburgh Sleep Quality Index, respectively. Age, sex, physical activity level, nutritional status, and fatigue were included as possible confounders. Multivariate linear and logistic regressions were performed. Higher values of anxiety (OR = 1.10), fatigue (OR = 1.04), and older age (OR = 1.08) were associated with an increased risk of falling (ABC < 67%). Greater muscle strength was associated with male sex and improved nutritional status (adjusted R2 = 0.39). On the other hand, being older and using sleeping medication were linked to poorer functional balance (adjusted R2 = 0.115). In conclusion, greater anxiety levels and the use of sleep medication were linked to a high risk of falling and poorer functional balance, respectively. No associations were found between muscle strength and sleep quality, anxiety, or depression.
In non-specific low back pain, is an exercise program carried out through telerehabilitation as effective as one carried out in a physiotherapy center? A controlled randomized trial
(Elsevier, 2023-06) Villatoro-Luque, Francisco J.; Rodríguez-Almagro, Daniel; Aibar-Almazán, Agustín; Fernández-Carnero, Samuel; Pecos-Martín, Daniel; Ibáñez-Vera, Alfonso J.; Achalandabaso-Ochoa, Alexander
Background: s:The effectiveness of telerehabilitation (TLRH) in patients with non-specific low back pain (NLBP) remains unknown. No study till date has investigated the efficacy of a mobile-based TLRH in patients with NLBP. Objectives: To investigate if a TLRH program is as effective as a clinical exercise programme in improving disability, pain intensity, pain catastrophizing, and hip pain and strength in patients with NLBP. Design: Single-blind, two-armed, randomized controlled study. Method: A total of 71 individuals with NLBP were randomly allocated to either the TLRH home group (TLRH) or clinic group (CG). The TLRH followed exercise videos and read information on pain neurophysiology. The CG performed the same exercises and received on-site pain education. Both groups performed the exercises twice weekly for 8 weeks. Disability, pain intensity, pain catastrophizing, and hip pain and strength were assessed at baseline, at post-treatment, and at three months. Results: Statistically significant differences for time-by-group interaction were detected in the strength of left hip flexors (supine [F = 8.356; p = .005]; sitting [F = 9.828; p = .003]), right hip extensors with extended knee [F = 7.461; p = .008], left hip extensors (extended knee [F = 13.175; p = .001]; flexed knee [F = 13.505; p < .001]), pain during flexion of the right [F = 5.133; p = .027] and left [F = 4.731; p = .033] hips in the supine position, disability [F = 4.557; p = .014], and pain catastrophizing [F = 14.132; p < .001]. Conclusion: A TLRH mobile-based is as effective as clinical treatment in improving disability, pain catastrophizing, and pain and strength of the hip structures in patients with NLBP.
The Female Sexual Function Index: reliability and validity in Spanish postmenopausal women.
(LIPPINCOTT WILLIAMS & WILKINS, 2019-04) Pérez-Herrezuelo, Isabel; Hita-Contreras, Fidel; Martínez-Amat, Antonio; Aibar-Almazán, Agustín; Cruz-Díaz, David; Wangensteen, Rosemary; Achalandabaso-Ochoa, Alexander; Díaz-Mohedo, Esther
Objective: To examine the reliability and validity of the Spanish version of the Female Sexual Function Index (FSFI) and its ability to discriminate between women with and without female sexual dysfunction (FSD) among Spanish postmenopausal women. Methods: A total of 152 postmenopausal women completed the Spanish version of FSFI. Internal consistency, test-retest reliability, and construct validity (exploratory factor analysis) were analyzed. Concurrent and divergent validity were assessed using a visual analogue scale for overall satisfaction with sexual life and the Hospital Anxiety and Depression Scale, respectively. To determine the ability and the accuracy of the FSFI total score in discriminating between women with and without FSD, a receiver operating characteristic (ROC) curve analysis was performed. Results: Factor analysis suggested a three-factor structure (explained variance 77.77%). The Spanish FSFI showed substantial-to-excellent test-retest reliability, with good internal consistency in the FSFI total score (Cronbach’s alpha=0.964) as well as in its three dimensions. The FSFI total and domains scores showed strong (r>0.50) and significant correlations (p<0.01) with overall satisfaction with sexual life (concurrent validity), and low correlations with anxiety and depression (divergent validity). The Spanish FSFI total score and dimensions were significantly able to discriminate between women with and without FSD (p<0.05), with an optimal cut-off point of <24.95 for the FSFI total score (64.15% sensitivity and 75.76% specificity). Conclusions: The Spanish FSFI is a valid and reliable instrument for assessing and discriminating for FSD among Spanish postmenopausal women.
Time course and predictors of persistent cancer-related fatigue in long-term breast cancer survivors: a prospective observational study
(SPRINGER, 2022-12-15) Álvarez-Salvago, Francisco; Jiménez-García, José D.; Martínez-Amat, Antonio; Hita-Contreras, Fidel; Aibar-Almazán, Agustín
Purpose: The present study investigated whether the level of cancer-related fatigue (CRF) after finishing oncology treatment was related to higher levels of persistent CRF and its relationship with both functional and psychological disturbances. Second, to identify potential predictors of persistent CRF. Methods: Eighty BC survivors were classified into non-fatigued (≤ 3.9) or fatigued (≥ 4), according to their Piper Fatigue Scale total score after finishing oncology treatment. The time course of fatigue and the impact on its domains, pain, mood state, perceived physical fitness, the level of physical activity, and quality of life were assessed at ≥ 5 years. Results: Women classified as fatigued after finishing oncology treatment had not only a higher prevalence of persistent CRF (41.2%) at the reassessment, but also greater levels of pain (P = .006 to .048) and mood disturbances (P = .007 to .015), and lower levels of physical fitness condition (P = .002 to .039) and quality of life (P < .001 to < .05) over time. Regression analyses revealed that "sadness/depression," "global health status," "physical activity level," and "type of treatment" were significant predictors of persistent CRF (r2 = .692). Conclusion: Higher levels of CRF implied greater levels of persistent CRF and a lower functional and psychological profile over time. 69.2% of of persistent CRF was explained.

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