Background: Motor impairments limit the functional abilities of patients after stroke; it is important to identify low-cost rehabilitation avenues. The aim of this study is to determine the effectiveness of thermal stimulation in addition to conventional therapy for functional recovery in post-stroke patients. Methods: An electronic search was performed in the MEDLINE, Scopus, Web of Science, EMBASE, CINAHL, SPORTDiscus, Epistemonikos, LILACS, and PEDro databases. The eligibility criterion was randomized clinical trials that analyzed the clinical effects of thermal stimulation plus conventional therapy. Two authors independently performed the search, study selection, data extraction, and risk of bias assessment. Results: Eight studies met the eligibility criteria, and six studies were included in the quantitative synthesis. For thermal stimulation plus conventional therapy versus conventional therapy alone, the mean difference (MD) for function was 6.92 points (95% CI = 4.36–9.48; p < 0.01), for motor function was 6.31 points (95% CI = 5.18–7.44; p < 0.01), for balance was 4.41 points (95% CI = −2.59–11.4; p = 0.22), and for walking was 1.01 points (95% CI = 0.33–1.69; p < 0.01). For noxious thermal stimulation versus innocuous thermal stimulation, the MD for activities of daily living was 1.19 points (95% CI = −0.46–2.84; p = 0.16). Conclusions: In the short term, adding thermal stimulation to conventional therapy showed statistically significant differences in functional recovery in post-stroke patients. The quality of evidence was high to very low according to GRADE rating. The studies included varied in the frequency and dosage of thermal stimulation, which may affect the consistency and generalizability of the results. A larger quantity and a better quality of clinical studies are needed to confirm our findings. PROSPERO registration: CRD42023423207.

There are no published studies that have investigated the occurrence of pain sensitization in patients with postoperative shoulder stiffness. The aim of this study was to describe the presence of pain sensitization and its association with risk factors in patients with shoulder stiffness following arthroscopic rotator cuff (RC) repair. From 2016 to 2020, a total of 115 patients with shoulder stiffness after RC repair were consecutive and prospectively recruited. All patients completed the Pain Sensitivity Questionnaire (PSQ). Additionally, sociodemographic, comorbidities, anthropometrics, clinical (Tampa Scale of Kinesiophobia [TSK]), and functional outcomes measures (Constant-Murley [CM], Disabilities of the Arm, Shoulder, and Hand [DASH] questionnaires, and Visual Analog Scale [VAS]) were analyzed as baseline predictors; measurements were assessed at 6 weeks after surgery. A total of 75 patients (65.2%) showed pain sensitization. The results showed a positive association between higher values of PSQ-total and a high number of comorbidities (β ​= ​3.5; p ​< ​0.001), higher values of body mass index (β ​= ​1.1; p ​= ​0.04), longer duration of symptoms (β ​= ​2.6; p ​< ​0.001), high level of irritability (β ​= ​4.1; p ​= ​0.01), higher values on the TSK (β ​= ​4.1; p ​< ​0.001), lower scores on the CM (β ​= ​1.4; p ​< ​0.01), higher scores on the DASH (β ​= ​1.9; p ​< ​0.001), and higher values on the VAS (β ​= ​4.2; p ​< ​0.001). A high percentage of patients with shoulder stiffness following arthroscopic RC showed pain sensitization 6 weeks after surgery. Factors such as a high number of comorbidities, fear of movement, and pain intensity are predictors of pain sensitization in these patients. Knowledge and understanding of risk factors should be used in the decision-making process for identification of risk factors for chronic pain after arthroscopic RC repair to enable better care of patients. III.

Background: The purpose of the research was to improve fine motor skills in children, girls with Down Syndrome between 4 to 9 years of age. It aims at optimizing their activities of daily living and obtaining a certain degree of functional independence. Objective: The implementation of Multisensory Stimulation for fine motor skills in Down Syndrome. Methods: This research was descriptive, cross-sectional, quantitative. A Pre and Post evaluation was applied using the Graphomotor Test, the Denver Test, the Goddard Test and the Fine Motor Calculation. It was based on the Technical Guidelines for Down Syndrome care of the Ministry of Health of El Salvador. The execution of Multisensory Stimulation was carried out in the Snoezelen Rooms with their respective activities. Results: An improvement in fine motor skills was observed after the application of Multisensory Stimulation and the different activities in the Snoezelen Rooms. Conclusions: The investigation was verified by means of the Shapiro-Wilk test taking into account the degrees of freedom (p≥0.05) H0 was accepted, where Multisensory Stimulation does improve fine motor skills in Down Syndrome. It allows boys/girls to have a better grip on their thenar clamp, which facilitates the different daily activities.

Previous studies suggest that craniofacial manual lymphatic drainage (MLD) facilitates brain fluids clearance, reducing intracranial pressure and reabsorbing chronic subdural hematoma. This study aimed to explore the effect of craniofacial MLD in combination with pharmacological treatment for improving cranial pain intensity, vital signs, and cerebral edema (Hounsfield units, HUs) in moderate traumatic brain injury (mTBI). Patient 1 received pharmacological therapy, while patient 2 received both pharmacological and craniocervical MLD treatment. Patient 2 showed decreased cranial pain intensity and systolic blood pressure (66%–11.11%, respectively) after two 30 min daily sessions of treatment for three days. HUs in the caudate nucleus of both hemispheres (left 24.64%–right 28.72%) and in the left temporal cortical gray matter increased (17.8%). An increase in HU suggests a reduction in cerebral edema and vice versa. For patient 1, there were no changes in cranial pain intensity, but a slight increase in the systolic blood pressure was observed (0%–3.27%, respectively). HUs decreased in the temporal cortical (14.98%) and caudate nucleus gray matter (9.77%) of the left and right cerebral hemispheres (11.96%–16.74%, respectively). This case study suggests that craniofacial MLD combined with pharmacological treatment could reduce cerebral edema, decrease head pain intensity, and maintain vital signs in normal physiologic values in patients with mTBI.

Early identification of neurodevelopmental trajectories is essential for timely intervention in infancy. While joint mobility is often seen as an indicator of motor capacity, its link to early functional performance remains unclear. This study examined whether active shoulder range of motion and the quality of spontaneous movement quality relate to early upper limb function in infants under three months. Thirty-two healthy infants participated in a cross-sectional assessment. Video recordings analyzed with the General Movements Assessment classified movements as Fidgety or Writhing. Fine motor performance was evaluated using five items from the Denver II Screening Test. Active shoulder abduction was measured via two-dimensional frontal-plane analysis with Kinovea^®. Data analysis involved t-tests and Pearson correlations. Results showed that infants with Fidgety movements scored higher on fine motor tests than those with Writhing movements. Shoulder range of motion was slightly higher in infants with Writhing movements, but not significantly. No sex differences were found. Weak, nonsignificant correlations existed between shoulder range of motion and fine motor performance. The findings suggest movement quality, rather than limb mobility, is more connected to early motor function. Combining movement quality assessments with simple tests may improve early detection of subtle neuromotor issues and guide early stimulation strategies.