Cristina Salar-Andreu’s research while affiliated with Universidad Cardenal Herrera CEU and other places

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Publications (3)


The Influence of the Weight of the Backpack on the Biomechanics of the Child and Adolescent: A Systematic Review and Meta-analysis With a Meta-Regression
  • Literature Review

April 2023

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162 Reads

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2 Citations

Pediatric Physical Therapy

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Purpose: To evaluate and explore the influence of the weight of a backpack on standing posture and gait in children and adolescents. Methods: We conducted a search of MEDLINE (PubMed), Cochrane Library, Cumulative Index to Nursing and Allied Health Literature (CINAHL), and Web of Science, with the last search in July 2021. Standardized mean differences (SMD) and 95% confidence intervals were calculated for relevant outcomes and were pooled in a meta-analysis using the random-effects model. The participants were healthy children or adolescents. The outcomes were postural variables, spatiotemporal gait variables, gait kinematics, and muscle activity. We analyzed the influence of a loaded backpack on posture while standing and spatiotemporal and kinematic variables while walking. We used GRADE, Risk of Bias 2, ROBINS-I, MINORS, and PEDro scales to rate the quality, certainty, and applicability of the evidence. Results: Wearing a loaded backpack induces a significant increase of the craniohorizontal angle while standing and a decrease of walking speed and stride length while walking. Only the craniovertebral angle had a significant relationship with the weight of the backpack. Conclusions: Wearing a backpack induces postural changes while standing and affects gait in children and adolescents; however, almost all the changes are not related to the backpack weight.


Reasons provided by the physical therapists that resulted in the reduction of scheduled appointments during the pandemic.
Reasons provided for COVID-19 vaccine acceptance.
Demographic and professional data of the physical therapists (n = 666).
Impact of COVID-19, vaccine acceptance and adverse effects of vaccination.
Impact of the COVID-19 Pandemic on the Work Activity of Spanish Physical Therapists and Their Response to Vaccination
  • Article
  • Full-text available

May 2022

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90 Reads

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1 Citation

Due to the COVID-19 pandemic, physical therapists have had to adopt a set of specific protection measures, which have had an impact on their clinical activity and economy. The objective was to evaluate the impact of the COVID-19 pandemic on the work of Spanish physical therapists, as well as their attitudes and predisposition to vaccination. An online questionnaire was divided into five sections: (1) demographic and professional data; (2) labor impact; (3) precautions and infection-control measures; (4) economic impact; and (5) vaccine acceptance and adverse effects. Of the 666 participants, 62.1% showed a reduction in their working hours motivated by: fear of infection (p = 0.007), financial issues (p = 0.002) and being in quarantine or isolation (p < 0.001). Of these, 36.4% were forced to close the clinic, 62.7% requested help from the government, but only 12.04% mentioned that it was adequate. The main prevention measures adopted were the use of gels and masks and, in the private sector, disinfection with ozone or ultraviolet light (p < 0.05). The acceptance of the vaccine was high, 87.5%, being lower among the group over 40 years of age, self-employed, widowed or separated. More adverse effects were mentioned after receiving the AstraZeneca-Oxford vaccine, compared to Pfizer-BioNTech or Moderna. In conclusion, this study assessed for the first time that the COVID-19 pandemic in Spain had a negative impact on work and finances of physical therapists. The vaccine was widely accepted, in part by the economic impact that an infection in the work setting could signify.

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Figure 1. Risk of bias graph according to the Risk of Bias 2 tool.
Figure 2. Sensitivity analysis of the depressive symptoms variable for telematic behavioral modification techniques against usual care or waiting list. Negative results favor the intervention group. The small boxes with the squares represent the point estimate of the effect size and sample size. The lines on either side of the box represent a 95% confidence interval (CI). e-BMT: Telematic Behavioral Modification Techniques.
Figure 3. Sensitivity analysis of the anxiety variable for telematic behavioral modification techniques against usual care or waiting list. Negative results favor the intervention group. The small boxes with the squares represent the point estimate of the effect size and sample size. The lines on either side of the box represent a 95% confidence interval (CI). e-BMT: Telematic Behavioral Modification Techniques.
Subgroup analysis.
Effectiveness of Telematic Behavioral Techniques to Manage Anxiety, Stress and Depressive Symptoms in Patients with Chronic Musculoskeletal Pain: A Systematic Review and Meta-Analysis

March 2022

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99 Reads

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6 Citations

Abstract: Anxiety, depressive symptoms and stress have a significant influence on chronic musculoskeletal pain. Behavioral modification techniques have proven to be effective to manage these variables, however, the COVID-19 pandemic has highlighted the need for an alternative to face-to-face treatment. We conducted a search of PubMed, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Web of Science, APA PsychInfo, and Psychological and Behavioural Collections. The aim was to assess the effectiveness of telematic behavioral modification techniques (e-BMT) on psychological variables in patients with chronic musculoskeletal pain through a sys-tematic review with meta-analysis. We used a conventional pairwise meta-analysis and a random-effects model. We calculated the standardized mean difference (SMD) with the corresponding 95% confidence interval (CI). 41 randomized controlled trial were included for a total of 5018 participants. We found a statistically significant small effect size in favor of e-BMT in depressive symptoms (n = 3531; SMD = -0.35; 95% CI -0.46, -0.24) and anxiety (n = 2578; SMD = -0.32; 95% CI -0.42, -0.21) with low to moderate strength of evidence. However, there was no statistically sig-nificant effect on stress symptoms with moderate strength of evidence. In conclusion, e-BMT is an effective option for the management of anxiety and depressive symptoms in patients with chronic musculoskeletal pain. However, it does not seem effective to improve stress symptoms.

Citations (2)


... This finding is also supported by previous research. Findings suggest that backpacks can impact the posture and walking patterns of children and adolescents, with most changes linked to the backpack's weight [47]. Consequently, this article strengthens the assertion that the extent of vertebral column bending in the sagittal plane caused by backpacks is directly correlated with their weight. ...

Reference:

Biomechanical comparison of sagittal vertebral column bend change induced by backpacks in school-aged children and adolescents: Systematic review and network meta-analysis
The Influence of the Weight of the Backpack on the Biomechanics of the Child and Adolescent: A Systematic Review and Meta-analysis With a Meta-Regression
  • Citing Article
  • April 2023

Pediatric Physical Therapy

... Although the causal relationship between MSKP, sleep deprivation, and psychological distress is not entirely understood, the associative relationship is bidirectional. For example, while some studies have shown that a significant proportion of those with MSKP suffer from psychological distress, others have found psychological distress to be resulting in MSKP [11,12]. Similarly, low back pain, the most commonly reported MSKP, has been found to be significantly associated with the quality of sleep quality [13], and on the other hand, a night of poor sleep quality has been reported to be followed by worsened MSKP intensity [14]. ...

Effectiveness of Telematic Behavioral Techniques to Manage Anxiety, Stress and Depressive Symptoms in Patients with Chronic Musculoskeletal Pain: A Systematic Review and Meta-Analysis