Objective: To assess the effectiveness of Extracorporeal Shock Wave Therapy (ESWT) to reduce lower limb spasticity in adult stroke survivors. Data Sources: A systematic review of Medline/Pubmed, CENTRAL, CINAHL, PEDro database, REHABDATA, Scielo, Scopus, Web of Science, Trip Database, and Epistemonikos from 1980 to December 2018 was carried out. Review Methods: The bibliography was screened to identify clinical trials (controlled and before-after) that used ESWT to reduce spasticity in stroke survivors. Two reviewers independently screened references, selected relevant studies, extracted data, and assessed risk of bias by PEDro scale. The primary outcome was spasticity. Results: A total of 12 studies (278 participants) were included (5 randomized controlled trials, 1 controlled trial, and 6 before-after studies). A meta-analysis was performed by randomized controlled trials. A beneficial effect on spasticity was found. The mean difference (MD) was 0.58; 95% confidence interval (CI) 0.30 to 0.86 and also in subgroup analysis (short, medium, and long term). The MD for range of motion was 1.81; CI −0.20 to 3.82 and for lower limb function the standard mean difference (SMD) was 0.34; 95% CI −0.09 to 0.77. Sensitivity analysis demonstrated a better beneficial effect for myotendinous junction. MD was 1.5; 95% CI −2.44 to 5.44 at long-term (9 weeks). Conclusion: The ESWT (radial/focused) would be a good non-invasive rehabilitation strategy in chronic stroke survivors to reduce lower limb spasticity, increase ankle range of motion, and improve lower limb function. It does not show any adverse events and it is a safe and effective method.

Objective: To assess the effect of therapeutic massage for improving sequelae in stroke survivors. Methods: A systematic review of the nine medical databases from January 1961 to December 2020 was carried out. The bibliography was screened to identify randomized controlled clinical trials (RCTs). Two reviewers independently screened references, selected relevant studies, extracted data and assessed the risk of bias using the PEDro scale. The primary outcome was upper and lower limb motor function and spasticity. Results: A total of 3196 studies were identified and 18 RCT were finally included (1989 individuals). A meta-analysis of RCTs in the comparison of Chinese massage (Tuina) plus conventional physiotherapy versus conventional physiotherapy was performed. The mean difference (MD) in the subacute stage on upper limb motor-function using the Fugl Meyer Assessment was 2.75; (95% confidence interval (CI) from 0.97 to 4.53, p = 0.002, I² = 36%). The MD on upper limb spasticity using modified Ashworth scale was −0.15; (95% CI from −0.24 to −0.06, p < 0.02, I² = 0%).The MD on lower limb spasticity was −0.59; (95% CI from −0.78 to −0.40, p < 0.001, I² = 0%) in the endpoint. Conclusions: Therapeutic massage, especially Tuina, in addition to conventional therapy is effective for improving motor function and for reducing spasticity in stroke survivors.

Introduction: Team-Based Learning (TBL) is an educational strategy designed for small groups that can be effectively implemented across various educational levels. The aim of TBL is the development of meaningful learning teams, facilitating student interaction and effective communication in problem-solving. It is hypothesized that the use of TBL demonstrates higher levels of satisfaction, engagement and responsibility regarding the acquisition of knowledge than the traditional method of master class. Methods: A cross-sectional study was carried out. Twenty-four university students enrolled in the subject of Clinical Reasoning and Evidence Based Practice of the Physiotherapy Master´s programme during the academic year 2022– 23 were included. Engagement, satisfaction and preferences were collected through the TBL Student Assessment Instrument (TBL-SAI). Results: Twenty-three students were included in the final analysis, with a mean age of 25.29 ± 3.84 years. The results obtained from the TBL-SAI indicated a score of 25.57 on the accountability subscale, 51.04 on the preference for this learning approach subscale, and 32.43 on the overall satisfaction subscale. Conclusion: Students found TBL to be engaging, fostering greater responsibility for both individual and group learning. Compared to traditional lectures, TBL sessions were preferred by students, reflecting a higher level of satisfaction with this collaborative learning approach. Further investigation is warranted to assess long-term knowledge retention and to ensure alignment between TBL activities and intended learning objectives.

Physical therapy programs are tasked with delivering an increasing volume of content to prepare graduates as healthcare professionals [1]. In order for students to be able to provide safe care for ...