Person: Fernández Carnero, Samuel
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Samuel
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Fernández Carnero
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Medicina
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Item Imaging with ultrasound in physical therapy: What is the PT’s scope of practice? A competency-based educational model and training recommendations.(British Journal of Sports Medicine, 2019) Whittaker, Jackie L; Ellis, Richard; Hodges, Paul William; OSullivan, Cliona; Hides, Julie; Fernández Carnero, Samuel; Arias Buría, José Luis; Teyhen, Deydre S; Stokes, Maria JPhysical therapists employ ultrasound (US) imaging technology for a broad range of clinical and research purposes. Despite this, few physical therapy regulatory bodies guide the use of US imaging, and there are limited continuing education opportunities for physical therapists to become proficient in using US within their professional scope of practice. Here, we (i) outline the current status of US use by physical therapists; (ii) define and describe four broad categories of physical therapy US applications (ie, rehabilitation, diagnostic, intervention and research US); (iii) discuss how US use relates to the scope of high value physical therapy practice and (iv) propose a broad framework for a competency-based education model for training physical therapists in US. This paper only discusses US imaging— not ’therapeutic’ US. Thus, ’imaging’ is implicit anywhere the term ’ultrasound’ is used.Item Rehabilitative Ultrasound Imaging Evaluation in Physiotherapy: Piloting a Systematic Review.(Applied Sciences, 2019) Fernández Carnero, Samuel; Arias Buría, José Luis; Cuenca Zaldívar , Juan Nicolás; Leal Quiñones, Alejandro; Calvo Lobo, César; Martín Saborido, CarlosBackground: Research of ultrasound use in physiotherapy and daily practice has led to its use as an everyday tool. Methods: The aims were: (1) Checking the proposed systematic review protocol methodology; (2) evaluating the evidence from the last five years; and (3) coordinating the work of the team of reviewers in performing a complete systematic review. Thus, this is a pilot study prior to a full systematic review. The findings in databases related to health sciences with the meta-search engine Discovery EBSCO, Covidence, and Revman were used. Inclusion and exclusion criteria were described for eligibility. Results: Search provided 1029 references regarding the lumbar region on ultrasound scans. Of these, 33 were duplicates. After Covidence, 996 studies were left for screening. A full-text reading brought one randomized clinical trial (RCT). Conclusions: Validity and reliability references were found. The most suitable points were novice versus expert, and ultrasound versus electromyography (EMG) with just one RCT cohort, and observational and case reports. The lines of investigation increasingly endorsed the validity of using ultrasound in physiotherapy. Post-acquisition image analysis could also be a future line of research.Item Validity and Reliability of Methods for Sonography Education in Physiotherapy: Onsite vs. Online.(Applied Sciences, 2020) Fernández Carnero, Samuel; Cuenca Zaldívar , Juan Nicolás; Pecos Martín, Daniel; ; Ferragut Garcías, Alejandro; Gallego Izquierdo, Tomás; Achalandabaso Ochoa, AlexanderBackground: in physiotherapy, the interest in sonography education has been increasing in recent decades, giving rise to opportunities in education in an attempt to meet the elevated demand. In other health professions, online education has demonstrated to be of interest, and another possibility by which to obtain knowledge. Methods: this exploratory observational prospective study compared the outcomes between onsite versus online education, and was approved by the ethics committee of the Francisco de Vitoria University. Two groups (onsite and online) with 136 attendants and two levels for each (basic and advanced) received the same content but through different presentations. Theoretical exams were conducted via “Kahoot” and practical exams using phantoms, and the results were subject to statistical analyses. Results: the average age of onsite participants was 29.5 (25–35.25) years and 34 (28.5–40.5) for the online participants, with a higher percentage of women. The average score ranks in the Kahoot_basic test were higher for both online groups corresponding to basic (group 1) and advanced (group 2) levels: 7 (6.5, 7.5) for group 1 and 7 (6.5, 8.5) for group 2 vs. the onsite groups: 6 (5.5, 7) for group 1 and 6 (5, 6.5) for group 2. In the practical exam, the model detected that a small negative difference between the Onsite 2 group and the total effect was significant with a low effect size (R2adjusted = 0.025) for the measurements of the hollow structure; the difference between the Online 2 and Onsite 1 group was positive (1.5026, SE = 0.5822) and significant (t = 2.5809, p = 0.0113), with a low effect size (R2adjusted = 0.016) for the solid structure depth measurement. Conclusions: the results showed that there could be an opportunity to access sonography knowledge through online education in physical therapy compared to the traditional onsite model. These conclusions support the use of a low-cost and accessible method for ultrasound educationItem The Role of Rehabilitative Ultrasound Imaging Technique in the Lumbopelvic Region as a Diagnosis and Treatment Tool in Physiotherapy: Systematic Review, Meta-Analysis and Meta-Regression.(Journal of Clinical Medicine, 2021) Fernández Carnero, Samuel; Martín Saborido, Carlos; ; Ferragut-Garcias, Alejandro; Cuenca Zaldívar, Juan Nicolás; Leal Quiñones, Alejandro; Calvo Lobo, César; Gallego Izquierdo, Tomás; Achalandabaso Ochoa, AlexanderRehabilitative ultrasound imaging (RUSI) technique seems to be a valid and reliable tool for diagnosis and treatment in physiotherapy and has been widely studied in the lumbopelvic region the last three decades. The aims for this utility in clinical settings must be review through a systematic review, meta-analysis and meta-regression. A systematic review was designed following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines with PROSPERO registration and per review in all phases of the process using COVIDENCE, analysis of risk of bias and meta-analysis using REVMAN, and meta-regression calculation using STATA. Database screening provided 6544 references, out of which 321 reported narrative synthesis, and 21 reported quantitative synthesis, while only 7 of them provided comparable data to meta-analyze the variables pain and muscle thickness. In most cases, the forest plots showed considerable I2 heterogeneity indexes for multifidus muscle thickness (I2 = 95%), low back pain (I2 = 92%) and abdominal pain (I2 = 95%), not important for transversus abdominis muscle thickness (I2 = 22%), significant heterogenity (I2 = 69%) depending on the subgroup and not important internal oblique muscle thickness (I2 = 0%) and external oblique muscle thickness (I2 = 0%). Meta-regression did not provide significant data for the correlations between the variables analyzed and the intervention, age, and BMI (Body Mass Index). This review reveals that RUSI could contribute to a high reliability of the measurements in the lumbopelvic region with validity and reliability for the assessments, as well as showing promising results for diagnosis and intervention assessment in physiotherapy compared to the traditional model, allowing for future lines of research in this area.Item Cadaveric and ultrasonographic validation of needling placement in the cervical multifidus muscle(Journal of Manipulative and Physiological Therapeutics, 2017) Fernández de las Peñas, César; Mesa Jiménez, Juan A.; Paredes Mancilla, Jose A.; Shane L., Koppenhaver; Fernández Carnero, SamuelObjective: The aim of this study was to determine if a needle is able to reach the cervical multifidus during the application of dry needling or acupuncture. Methods: Dry needling and ultrasound imaging of cervical multifidi was conducted on 5 patients (age: 32 ± 5 years) with mechanical neck pain and on 2 fresh cadavers (age: 64 ± 1 years). Dry needling was done using a needle of 40 mm in length inserted perpendicular to the skin about 1 cmlateral to the spinous process at C3-C4. The needlewas advanced from a posterior to anterior direction into the cervical multifidus with a slight inferior-medial angle (approximately 10°) to reach the vertebra lamina. For the cadaveric study, the multifidus was isolated by carefully resecting the superficial posterior cervical muscles: trapezius, splenius, and semispinalis. For the ultrasonographic study, a convex transducer was placed transversely over C3-C4 after the insertion of the needle into the muscle. Results: The results of both the cadaveric and ultrasonic studies found that the needle does pierce the cervical multifidus muscle during insertion and that the tip of the needle rests properly against the vertebral laminae, thereby guarding the sensitive underlying spinal structures from damage. Conclusion: This anatomical and ultrasound imaging study supports that dry needling of the cervical multifidus could be conducted clinically. (J Manipulative Physiol Ther 2017;xx:0-6)Item Evaluación de la Técnica Ecográfica (RUSI - Rehabilitative Ultrasound Imaging) en el diagnóstico y tratamiento en Fisioterapia. Revisión Sistemática.(2020) Fernández Carnero, Samuel; Martín Saborido, Carlos; Doctorado en Biotecnología, Medicina y Ciencias BiosanitariasEsta revisión sistemática se propuso evaluar las posibilidades de la técnica RUSI (Rehabilitative Ultrasound Imaging) para el diagnóstico y tratamiento en Fisioterapia. Por ello se hizo una búsqueda lo mas amplia posible siguiendo las recomendaciones del manual Cochrane y tratar de evaluar lo mas ampliamente posible toda la evidencia. En primer lugar, se conformó un equipo de revisores puesto que se comprobó en las búsquedas previas un elevado número de trabajos científicos en este nivel. El objeto de revisión se centró en la región lumbopélvica (estructurándolo en abdomen, lumbares y suelo pélvico) y la revisión se inscribió en PROSPERO. Además, se llevó a cabo un pilotaje para testar la capacidad de evaluación del equipo de revisores y poder detectar errores o faltas que pudieren afectar a la revisión sistemática completa. Fruto de este pilotaje fue la publicación en revista de impacto (JCR): “Rehabilitative Ultrasound Imaging Evaluation in Physiotherapy: Piloting a Systematic Review” y con el DOI: https://doi.org/10.3390/app9010181 Seguidamente se lanzó la revisión sistemática completa utilizando la herramienta COVIDENCE para que dos revisores siempre diesen dos opiniones sobre un trabajo y un tercer revisor pudiese resolver en casos de conflicto. De los resultados conseguidos se hizo análisis de sesgos utilizando la herramienta REVMAN. Los resultados obtenidos nos mostraron el elevado número de trabajos publicados, tan solo en la región lumbopélvica, mas de 6.000, concluyendo 321 trabajos para la fase lectura a texto completo. Si bien es cierto que solo se aceptaron estudios clínicos aleatorizados, los cuales solo cumplían 21 documentos de los cuales tenían criterios para ser comparados 7. Este desarrollo se puede observar en el diagrama PRISMA resultante. De el análisis de esos trabajos destacamos lo escaso que resultaron los estudios clínicos randomizados y que el uso de escalas de valoración e incluso la metodología de aplicación de técnicas de intervención resultó demasiado variable y poco homogéneo.