Virtual reality (VR) therapies are presently utilized to treat physical and cognitive impairments among elderly people. This systematic review aims to collect the most recent evidence on the effectiveness of VR in improving balance and gait among healthy elderly individuals, in comparison with other therapies. A literature search was conducted using the PubMed, SCOPUS, PEDro, and WoS databases, by selecting randomized clinical trials that evaluated balance, both static and dynamic, as well as gait in a population of healthy older adults who underwent virtual reality therapy. The methodological quality of the studies was assessed using the PEDro scale. After eligibility criteria were applied and duplicates were removed, 20 studies were selected out of 1705 initially identified. The present systematic review concludes that virtual reality therapy is more effective than minimal intervention or usual care in enhancing static balance, dynamic balance, and gait in healthy elderly individuals. Moreover, virtual reality therapy yields better outcomes compared to traditional balance training and physical exercise in improving balance and gait in this demographic. However, both methods have shown effectiveness.

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.

The Helkimo Clinical Dysfunction Index (HCDI) is a simple and quick test used to evaluate subjects affected by temporomandibular disorders (TMDs), and its psychometric properties have not been tested. The test evaluates movement, joint function, pain and musculature, providing a quick general overview that could be very useful at different levels of care. For this reason, the aim of this study was to validate the use of the HCDI in a sample of patients with TMD. Methods: The sample consisted of 107 subjects, 60 TMD patients and 47 healthy controls. The study evaluated concurrent validity, inter-rater concordance and predictive values. Results: The HCDI showed moderate to substantial inter-rater concordance among the items and excellent concordance for the total scores. The correlation with other TMD assessment tests was high, the correlation with dizziness was moderate and the correlation with neck pain, headache and overall quality of life was poor. The prediction of TMD showed a sensitivity of 86.67%, a specificity of 68.09% and an area under the curve (AUC) of 0.841. Conclusions: The HCDI is a valid and reliable assessment instrument; its clinimetric properties are adequate, and it has a good ability to discriminate between TMD-affected and TMD-unaffected subjects.

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 Fonseca Anamnestic Index (FAI) offers a simple method to screen temporomandibular disorders (TMD). This study aimed to validate the Spanish version of the FAI in patients with TMD. Methods: The sample consisted of 125 subjects (66 TMD and 59 controls) aged over 18 years. Construct validity, internal consistency, test-retest reliability, concurrent validity and capacity to discriminate between TMD and healthy subjects were analyzed. Results: The Spanish version of the FAI showed a structure formed by three factors. Cronbach’s alpha was 0.826. The reliability of the items varied between substantial to almost perfect and was excellent for the total score (intraclass correlation coefficient = 0.937). The standard error of measurement (SEM) was 6.52, with a minimum detectable change (MDC) of 12.78. FAI score showed a significant correlation with headache, neck pain and vertigo measurements. A cut-off point >35 showed a sensitivity = 83.33% and a specificity = 77.97% in differentiating between healthy and TMD patients, with an area under the curve (AUC) = 0.865. Conclusions: The Spanish version of the FAI is a valid and reliable instrument for diagnosing people with TMD, with appropriate general clinimetric properties. Discrimination between patients with and without TMD is excellent.

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.