Examinando por Autor "Gutiérrez-Arias, Ruvistay"
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Ítem Can resistance exercise prevent breast cancer–related lymphoedema? A systematic review and metanalysis protocol(BMJ Publishing Group, 2024-11-19) Aguilera-Eguía, Raúl Alberto; Seron, Pamela; Gutiérrez-Arias, Ruvistay; Zaror, CarlosIntroduction Evidence shows that resistance training (RT) reduces lymphoedema in patients with breast cancer–related lymphoedema (BRCL), making it a safe and efficient intervention. However, it is uncertain if RT is safe and effective in patients at risk of developing BRCL. This systematic review (SR) protocol aims to describe all methodological aspects in order to evaluate the short-, medium- and long-term effects of RT on the prevention of BCRL. Materials and methods Throughout 2024, randomised clinical trials (RCTs) will be identified in electronic databases MEDLINE/PubMed, Embase, Cochrane Central Register of Controlled Trials, PEDro and LILACS. Only studies in English, Spanish and Portuguese will be included. Grey literature and clinical trial registration will also be reviewed. The primary outcome will be the occurrence of lymphoedema and quality of life. Second, pain intensity, upper limb function, range of movement, grip strength and adverse events will be considered. The individual studies’ risk of bias will be evaluated using the Cochrane Risk of Bias 2.0 tool. Pairwise meta-analyses using a frequentist approach and random effects model will be conducted. The Grading of Recommendations Assessment, Development and Evaluation system will be used to evaluate the certainty of the evidence. Ethics and dissemination This protocol does not require the approval of an ethics committee, as it is a secondary study. The results will be disseminated through peer-reviewed publications.Ítem Can resistance exercise prevent breast cancer–related lymphoedema? A systematic review and metanalysis protocol(BMJ Publishing Group, 2024-11-19) Aguilera-Eguía, Raúl Alberto; Seron, Pamela; Gutiérrez-Arias, Ruvistay; Zaror, CarlosIntroduction Evidence shows that resistance training (RT) reduces lymphoedema in patients with breast cancer–related lymphoedema (BRCL), making it a safe and efficient intervention. However, it is uncertain if RT is safe and effective in patients at risk of developing BRCL. This systematic review (SR) protocol aims to describe all methodological aspects in order to evaluate the short-, medium- and long-term effects of RT on the prevention of BCRL. Materials and methods Throughout 2024, randomised clinical trials (RCTs) will be identified in electronic databases MEDLINE/PubMed, Embase, Cochrane Central Register of Controlled Trials, PEDro and LILACS. Only studies in English, Spanish and Portuguese will be included. Grey literature and clinical trial registration will also be reviewed. The primary outcome will be the occurrence of lymphoedema and quality of life. Second, pain intensity, upper limb function, range of movement, grip strength and adverse events will be considered. The individual studies’ risk of bias will be evaluated using the Cochrane Risk of Bias 2.0 tool. Pairwise meta-analyses using a frequentist approach and random effects model will be conducted. The Grading of Recommendations Assessment, Development and Evaluation system will be used to evaluate the certainty of the evidence. Ethics and dissemination This protocol does not require the approval of an ethics committee, as it is a secondary study. The results will be disseminated through peer-reviewed publications.Ítem Effectiveness of physical exercise programmes in reducing complications associated with secondary lymphoedema to breast cancer: a protocol for an overview of systematic reviews(NLM (Medline), 2023-07) Aguilera-Eguía, Raúl Alberto; Gutiérrez-Arias, Ruvistay; Zaror, Carlos; Seron, PamelaINTRODUCTION: Breast cancer-related lymphoedema (BCRL) is one of the most underestimated and debilitating complications associated with the treatment that women with breast cancer receive. Several systematic reviews (SRs) of different physical exercise programmes have been published, presenting disperse and contradictory clinical results. Therefore, there is a need for access to the best available and summarised evidence to capture and evaluate all the physical exercise programmes that focus on reducing BCRL. OBJECTIVE: To evaluate the effectiveness of different physical exercise programmes in reducing the volume of lymphoedema, pain intensity and improving quality of life. METHOD AND ANALYSIS: The protocol of this overview is reported following the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols, and its methodology is based on Cochrane Handbook for Systematic Reviews of Interventions. Only those SRs involving physical exercise by patients with BCRL will be included, whether on its own or combined with other exercises or other physical therapy interventions.The outcomes of interest to be considered will be lymphoedema volume, quality of life, pain intensity, grip strength, range of motion, upper limb function and any adverse event. The MEDLINE/PubMed, Lilacs, Cochrane Library, PEDro and Embase databases will be searched for reports published from database inception to April 2023.Two researchers will perform study selection, data extraction and risk of bias assessment independently. Any discrepancy will be resolved by consensus, or ultimately, by a third-party reviewer. We will use Grading of Recommendations Assessment, Development and Evaluation System to assess the overall quality of the body of evidence. ETHICS AND DISSEMINATION: The results of this overview will be published in peer-reviewed scholarly journals and the scientific dissemination will take place in national or international conferences. This study does not require approval from an ethics committee, as it does not directly collect information from patients. PROSPERO REGISTRATION NUMBER: CRD42022334433. © Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.Ítem Estimulación eléctrica neuromuscular en el paciente crítico. Una revisión narrativa(Sociedad de Anestesiologia de Chile, 2022) Gutiérrez-Arias, Ruvistay; Contreras, Yorschua JalilAdvances in the treatment of critically ill patients have led to increased survival rates. However, survivors often experience significant consequences associated with the conventional model of care, in which patients tend to remain inactive, particularly during treatment with mechanical ventilation (MV) and prolonged use of sedation. This can result in mental, psychological, speech and swallowing disorders, and/or physical sequelae, including muscle weakness and consequent physical disability, which in many cases persist after discharge. Current evidence suggests that neuromuscular electrical stimulation has a positive effect on the mass and strength of the stimulated muscles, and may also induce systemic pro-myogenic, anti-inflammatory and regenerative effects, which could influence a decrease in MV time among other benefits. These effects could impact outcomes relevant to decision-makers, such as reduced intensive care unit length of stay and total hospitalization time. © 2022 Sociedad de Anestesiologia de Chile. All rights reserved.Ítem How a Developing Country Faces COVID-19 Rehabilitation: The Chilean Experience(Frontiers Media S.A., 2022-07) Torres-Castro, Rodrigo; Neculhueque-Zapata, Ximena; Hrzic-Miranda, Katherina; Gutiérrez-Arias, Ruvistay; Valenzuela-Suazo, Raúl; Castro-Acuña, Cristobal; Ríos-Quevedo, Marianela; Águila-Villanueva, Camilo; Seron, PamelaThe coronavirus 19 (COVID-19) pandemic has been one of the most significant challenges to public health in recent decades. The heterogeneity of government responses and the varying preparedness of health systems has determined that the pandemic's impact differs from country to country. Chile is no stranger to the challenges posed by rehabilitation in a developing country. We aimed to describe the approach to rehabilitation during the pandemic in Chile in the public health system since rehabilitation is considered a relevant health strategy from the prevention to management of complications, mitigation of sequelae, or new complications associated with COVID-19. For this, a descriptive study was conducted on the rehabilitation strategies implemented by Chile to respond to the COVID-19 pandemic. The analysis includes the context of the Chilean health system and the matrix of access to rehabilitation services in COVID-19. The Health Ministry (MINSAL) rehabilitation strategy includes five central axes: approaches, specific lines, transversal lines, intervention, and funding. Additionally, the policies were based and supported by the WHO recommendations. Intensive care unit beds were increased approximately 68%, and the primary care response was the reconversion of function depending on the epidemiological context. During the 2021–2022 period, the estimated number of people diagnosed with a post-COVID-19 condition was 80,528. With this, we can conclude that a developing country has managed to coordinate a rehabilitation policy for people with COVID-19 by generating a structure of the different health system levels. However, the effectiveness of this policy will need to be evaluated in the future. Copyright © 2022 Torres-Castro, Neculhueque-Zapata, Hrzic-Miranda, Gutiérrez-Arias, Valenzuela-Suazo, Castro-Acuña, Ríos-Quevedo, Águila-Villanueva and Seron.Ítem Implementation of an Objective structured clinical examination (OSCE) as a tool to evaluate the development of clinical reasoning in physical therapy students(Universidad Nacional de Colombia, 2022) Figueroa-Arce, Nicole; Figueroa-González, Paola; Gómez-Miranda, Luis; Gutiérrez-Arias, Ruvistay; Contreras-Pizarro, VivianaIntroduction: Clinical reasoning involves critical thinking and decision-making in clinical situations. It can be evaluated using Objective structured clinical examination (OSCE), which measures clinical skills associated with the development of clinical reasoning. Objective: To describe the implementation of an OSCE to evaluate the clinical skills associated with the development of clinical reasoning in physical therapy students, and to determine their level of satisfaction with this methodology. Materials and methods: Cross-sectional descriptive study conducted in 159 physical therapy students from Universidad Andres Bello, Chile, enrolled in the Reasoning in Physical therapy course (second semester of 2018). The OSCE had 11 stations and a student satisfaction survey was administered. Data normality was determined using the Shapiro-Wilk test. Descriptive statistics (percentages, medians, and interquartile ranges (IQR)) were used for data analysis. Results: The median global score was 142 points (IQR: 132-150) and 61.1% of the students obtained a passing score (≥ 134 points). Stations in which most students had a passing score were S3, S5 and S7 (standardized patient stations): 78.62%, 96.85% and 85.53%, respectively. Regarding the satisfaction survey, 36.48% and 59.12% of the students agreed and strongly agreed with using tools that assess their clinical skills. Conclusions: The OSCE was successfully designed and implemented to evaluate the clinical skills associated with the development of clinical reasoning in physical therapy students, and most of them reported a high level of satisfaction with its use; this confirms OSCE is an excellent methodology to train and evaluate these students. © 2021 Universidad Nacional de Colombia.Ítem Which physical therapy intervention is most effective in reducing secondary lymphoedema associated with breast cancer? Protocol for a systematic review and network meta-analysis(BMJ Publishing Group, 2022-09) Aguilera-Eguía, Raúl Alberto; Seron, Pamela; Gutiérrez-Arias, Ruvistay; Zaror, CarlosIntroduction Lymphoedema associated with breast cancer is caused by an interruption of the lymphatic system, together with factors such as total mastectomy, axillary dissection, positive lymph nodes, radiotherapy, use of taxanes and obesity. Physiotherapy treatment consists of complex decongestive therapy, manual lymphatic drainage and exercises, among other interventions. Currently, there are several systematic review and randomised controlled trials that evaluate the efficacy of these interventions. However, at present, there are no studies that compare the effectiveness of all these physical therapy interventions. The purpose of this study is to determine which physical therapy treatment is most effective in reducing breast cancer-related lymphoedema, improving quality of life and reducing pain. Methods and analysis MEDLINE, PEDro, CINAHL, EMBASE, LILACS and Cochrane Central Register of Controlled Trials will be searched for reports of randomised controlled trials published from database inception to June 2022. We will only include studies that are written in English, Spanish and Portuguese. We will also search grey literature, preprint servers and clinical trial registries. The primary outcomes are reduction of secondary lymphoedema associated with breast cancer, improvements in quality of life and pain reduction. The risk of bias of individual studies will be evaluated using the Cochrane Risk of Bias 2.0 Tool. A network meta-analysis will be performed using a random-effects model. First, pairs will be directly meta-analysed and indirect comparisons will be made between the different physical therapy treatments. The GRADE system will be used to assess the overall quality of the body of evidence associated with the main results.