Person: Sánchez Jorge, Sandra
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Sandra
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Sánchez Jorge
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Ciencias de la Salud
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Item Association between Gray-Scale Ultrasound Imaging and Serological Creatine Kinase for Quantifying Exercise-Induced Muscle Damage: An Observational Study.(Bioengineering, 2024) Buffet García, Jorge; Vicente Campos, Davinia; López Redondo, Mónica; Sánchez Jorge, Sandra; Álvarez González, Javier; Plaza-Manzano, Gustavo; Seijas-Fernández, Tamara; Valera-Calero, Juan AntonioLimited evidence has verified if ultrasound imaging (US) can detect post-exercise muscle damage based on size, shape, and brightness metrics. This study aimed to analyze the correlation between creatine kinase (CK) concentration and (as a biomarker of muscle damage) changes in US gray-scale metrics after an exercise-induced muscle damage protocol. An observational study was conducted at a private university lab located in Madrid. Twenty-five untrained and asymptomatic volunteers were enrolled in this study. Baseline demographic data and body composition metrics were collected. In addition, the rectus femoris US data and CK concentration were assessed at baseline and after inducing muscle damage (24 and 48 h later). After calculating time differences for all the outcomes, the correlation between the changes observed with US and biomarkers was assessed. Significant CK concentration increases were found 24 h (p = 0.003) and 48 h (p < 0.001) after exercise. However, no significant changes in muscle size, shape, or brightness were found in any location (p > 0.05 for all). In addition, no significant associations were found between CK changes and US changes (p > 0.05 for all). Gray-scale US is not a sensitive tool for detecting muscle damage, as a protocol of exercise-induced muscle damage confirmed with CK produced no significant gray-scale US changes after 24 or 48 h. In addition, US and CK changes after 24 and 48 h were not associated with each other.Item A novel mobile phone and tablet application for automatized calculation of pain extent.(Computers in Biology and Medicine, 2023) Valera-Calero, Juan Antonio; López-Zanoni, Darío; Sánchez Jorge, Sandra; Fernández-de-las-Peñas, César; Navarro-Santana, Marcos José; Calvo-Moreno, Sofía Olivia; Plaza-Manzano, GustavoBackground: Pain drawings (PDs) are used for assessing pain extent as a complementary outcome to other pain measurements, consisting of shading a body chart template to report the location and extent of pain. However, the accuracy and reliability of digital PDs remain controversial due to the heterogeneity of methods used. This study aimed to develop an easy-to-use application for assessing its diagnostic accuracy in comparison with the classic paper-and-pencil method. Methods: A test-retest reliability study was conducted, recruiting 95 patients with musculoskeletal pain symptoms. Participants shaded 2 sets of 3 different PDs (paper-and-pencil PD, digital PD using the finger and digital PD using the digital stylus). Intraclass correlation coefficients (ICC), standard error of measurement and minimal detectable changes (MDC) were calculated for each method. Finally, repeated measure analysis of variance assessed the mean differences between trials and methods and the convergent validity between methods was calculated using Pearson’s correlation coefficients. Results: All methods were excellently reliable (all, ICC>0.94). However, digital PDs obtained higher ICCs (ICC≥0.970) and greater accuracy to detect whether changes reflect a real change and are not due to a measurement errors (MDC = 0.72%– 0.80 % for digital PDs versus MDC = 1.13 % for paper-and-Pencil PDs). No significant score differences were found among the instruments for assessing pain extent (p > 0.05). Finally, the PAIN EXTENT app showed adequate convergent validity (r > 0.850). Conclusion: The PAIN EXTENT app is a fast and easy-to-use instrument compatible with operative systems and devices commonly used for assessing and monitoring pain extent in the clinical and research settings.Item Skin Bioimpedance Analysis to Determine Cellular Integrity by Phase Angle in Women with Fibromyalgia: A Cross-Sectional Study.(Biomedicines, 2023) Vicente Campos, Davinia; Sánchez Jorge, Sandra; Martí, Luis; Buffet, Jorge; Mendoza Laiz, Nuria; Rodriguez-Sanz, David; Becerro-de-Bengoa-Vallejo, Ricardo; Chicarro, J. L.; Calvo Lobo, CésarOxidative stress has been proposed as a significant part of the pathogenesis of fibromyalgia, and the phase angle in bioelectrical impedance analysis has been explored as a potential technique to screen oxidative abnormalities. This study recruited 35 women with fibromyalgia and 35 healthy women, who underwent bioelectrical impedance analysis and maximum isometric handgrip strength tests. Women with fibromyalgia showed lower bilateral handgrip strength (right hand: 16.39 ± 5.87 vs. 27.53 ± 4.09, p < 0.001; left hand: 16.31 ± 5.51 vs. 27.61 ± 4.14, p < 0.001), as well as higher body fat mass (27.14 ± 10.21 vs. 19.94 ± 7.25, p = 0.002), body fat percentage (37.80 ± 8.32 vs. 30.63 ± 7.77, p < 0.001), and visceral fat area (136.76 ± 55.31 vs. 91.65 ± 42.04, p < 0.01) compared with healthy women. There was no statistically significant difference in muscle mass between groups, but women with fibromyalgia showed lower phase angles in all body regions when compared with healthy control women (right arm: 4.42 ± 0.51 vs. 4.97 ± 0.48, p < 0.01; left arm: 4.23 ± 0.48 vs. 4.78 ± 0.50, p < 0.001; trunk: 5.62 ± 0.77 vs. 6.78 ± 0.84, p < 0.001; right leg: 5.28 ± 0.56 vs. 5.81 ± 0.60, p < 0.001; left leg: 5.07 ± 0.51 vs. 5.69 ± 0.58, p < 0.001; whole body: 4.81 ± 0.47 vs. 5.39 ± 0.49, p < 0.001). Moreover, whole-body phase-angle reduction was only predicted by the presence of fibromyalgia (R 2 = 0.264; β = 0.639; F(1,68) = 24.411; p < 0.001). Our study revealed significantly lower phase angle values, lower handgrip strength, and higher fat levels in women with fibromyalgia compared to healthy controls, which are data of clinical relevance when dealing with such patients.Item Changes in stiffness at active myofascial trigger points of the upper trapezius after dry needling in patients with chronic neck pain: a randomized controlled trial.(Acupuncture in Medicine, 2022) Valera-Calero, Juan Antonio; Sánchez Jorge, Sandra; Buffet García, Jorge; Varol, Umut; Fernández-de-las-Peñas, César; Álvarez González, JavierBackground/objective: Since, to our knowledge, the effects of dry needling (DN) on active myofascial trigger point (MTrP) stiffness have not been analyzed previously with shear wave elastography (SWE), our aim was to compare the effects of a single session of DN and sham DN applied to the most active MTrP located in the upper trapezius muscle on clinical outcomes. Methods: A randomized, double-blinded sham-controlled trial was conducted; 60 patients were randomized into an experimental (DN) or sham (sham DN) group. Baseline data including sociodemographic and clinical characteristics were collected. SWE and pain pressure thresholds (PPTs) at the MTrP and a control point located 3 cm laterally were the main outcomes assessed before and 10 min after the interventions. Results: Patients receiving DN interventions experienced greater increases in the control point PPTs immediately after receiving the intervention compared with sham DN (p < 0.05), but no differences were found for the MTrP (p > 0.05). Post-intervention PPT improvements were found at both locations for both groups (p < 0.01). No significant changes for either MTrP or control locations were found for SWE outcomes in either group (all ps > 0.05). No significant withingroup SWE differences were found in the DN or sham DN groups (p > 0.05). Conclusion: A single session of DN or sham DN applied to active MTrPs located in the upper trapezius muscle produced no detectable changes in stiffness at the MTrP or control locations. Real DN induced an immediate analgesic response at both MTrP and control locations, while sham DN induced an immediate MTrP response. Trial registration number: NCT04832074 (ClinicalTrials.gov).Item Antioxidant vitamin supplementation on muscle adaptations to resistance training: A double-blind, randomized controlled trial.(Nutrition, 2023) Martínez-Ferrán, María; Berlanga, Luis A.; Barcelo-Guido, Olga; Matos Duarte, Michelle; Vicente Campos, Davinia; Sánchez Jorge, Sandra; Romero Morales, Carlos; Munguía-Izquierdo, Diego; Pareja-Galeano, HeliosObjectives The aim of this study was to examine whether antioxidant vitamin supplementation with vitamin C (VitC) and vitamin E (VitE) affects the hypertrophic and functional adaptations to resistance training in trained men. Methods This was a double-blind, randomized controlled trial in which participants were supplemented daily with VitC and VitE ( n = 12) or placebo ( n = 11) while completing a 10-wk resistance training program accompanied by a dietary intervention (300 kcal surplus and adequate protein intake) designed to optimize hypertrophy. Body composition (dual-energy x-ray absorptiometry), handgrip strength, and one-repetition maximum (1-RM), maximal force (F0), velocity (V0), and power (Pmax) were measured in bench press (BP) and squat (SQ) tests conducted before and after the intervention. To detect between-group differences, multiple-mixed analysis of variance, standardized differences, and qualitative differences were estimated. Relative changes within each group were assessed using a paired Student's t test. Results In both groups, similar improvements were produced in BP 1-RM , SQ 1-RM SQ, and BP F0 (P < 0.05) after the resistance training program. A small effect size was observed for BP 1-RM (d = 0.53), BP F0 (d = 0.48), and SQ 1-RM (d = –0.39), but not for SQ F0 (d = 0.03). Dominant handgrip strength was significantly increased only in the placebo group (P < 0.05). According to body composition data, a significant increase was produced in upper body fat-free mass soft tissue (FFMST; P < 0.05) in the placebo group, whereas neither total nor segmental FFMST was increased in the vitamin group. Small intervention effect sizes were observed for upper body FFSMT (d = 0.32), non-dominant and dominant leg FFMST (d = –0.39; d = –0.42). Although a significant increase in total body fat was observed in both groups (P < 0.05) only the placebo group showed an increase in visceral adipose tissue (P < 0.05), showing a substantial intervention effect (d = 0.85). Conclusions The data indicated that, although VitC/VitE supplementation seemed to blunt upper body strength and hypertrophy adaptations to resistance training, it could also mitigate gains in visceral adipose tissue elicited by an energy surplus.Item POWERbreathe® Inspiratory Muscle Training in Amyotrophic Lateral Sclerosis.(Journal of Clinical Medicine, 2022) Vicente Campos, Davinia; Sánchez Jorge, Sandra; López Chicharro, José; Becerro-de Bengoa-Vallejo, Ricardo; Rodriguez-Sanz, David; ; Rivoire, Marie; Benet, Astrid; Boubekeur, Sofía; Calvo Lobo, César; García, Arianne RInspiratory muscle training may benefit respiratory function, cardiocirculatory parameters, quality of life and functionality in neuromuscular diseases. This pilot study aimed to demonstrate the POWERbreathe® inspiratory muscle training effects on maximum inspiratory pressure (PImax), heart rate (HR) and HR variability, as well as the quality of life impairment and functionality in patients with Amyotrophic Lateral Sclerosis (ALS). A pilot single-blinded, non-randomized controlled clinical trial was carried out. A total of 20T ALS patients were enrolled and divided into experimental (n = 10) and control (n = 10) groups. The experimental group received POWERbreathe® inspiratory muscle training in conjunction with usual care, and the control group received only usual care for 8 weeks. PImax (measured by POWERbreathe® KH1), HR and HR variability (evaluated by Polar H7), quality of life impairment [measured by the Amyotrophic Lateral Sclerosis Assessment Questionnaire—40 items (ALSAQ-40)] and functionality [assessed by the ALS Functional Rating Scale Revised (ALSFRS-R)] were collected at baseline and after 8 weeks of intervention. We detected statistically significant differences (p < 0.05) with an effect size ranging from medium to large (Cohen’s d = 0.72–1.37); relative to the control group, the experimental group had an increased PImax (mean difference = 10.80 cm H2O; 95% CI = 3.42–18.17) and ALSFRS-R score (mean difference = 5.30 points; 95% CI = −0.03–10.63) and reduced HR (mean difference = −8.80 beats-per-minute; 95% CI = −20.27–2.67) and R-R interval (mean difference = 78.30 ms; 95% CI = 2.89–153.70). POWERbreathe® inspiratory muscle training, in addition to usual care, may improve inspiratory strength and heart rate in patients with ALS. These results encourage larger and longer trials investigating potential clinically relevant benefits of inspiratory muscle training to these patients over the disease course.Item Estimating fat-free mass in recreationally resistance-trained young men: Longitudinal and cross-sectional validation of different methods.(Nutrition Research, 2023) Martínez Ferrán, María; Berlanga, L. A.; Barcelo Guido, Olga; Matos Duarte, Michelle; Vicente Campos, Davinia; Sánchez Jorge, Sandra; Romero Morales, Carlos; Casla Barrio, Soraya; Munguía Izquierdo, Diego; Pareja Galeano, HeliosSeveral techniques exist to measure fat-free mass (FFM). Accordingly, this study is based on data from our recent trial comparing the sensitivity of the main field methods available with that of dual-energy X-ray absorptiometry (DXA) as reference and analyzing the cross-sectional accuracy of these field methods in recreationally resistance-trained males. We hypothesized that the use of these techniques would lead to varying estimates of FFM compared with DXA. Participants (N = 23; 21.4 ± 3.3 years) completed a 10-week resistance training plus diet intervention designed to optimize hypertrophy. FFM was determined by bioelectrical impedance analysis (BIA), 23 anthropometric equations, and DXA. After the intervention, FFM increased significantly according to BIA and most anthropometric estimates, but this increase was not detected by 2 anthropometric equations or by DXA. Only 1 of these 2 equations showed significant correlation with DXA and no standardized or significant differences to this reference method, although it did display significant heteroscedasticity. In our cross-sectional analysis, only 1 anthropometric equation gave rise to good accuracy as confirmed by DXA. Our findings indicate that the use of different techniques to assess FFM gains in response to a hypertrophic intervention yields different results. BIA with general embedded equations should not be used to monitor a young male adult's body composition. To monitor FFM over time, we would recommend the Dunne et al. equation (2) as the most sensitive field method, and to assess FFM cross-sectionally, equation (1) of these authors is the most accurate field method.Item Immediate Effects of Bilateral Neuromuscular Taping on Upper Trapezius Muscle in Patients with Chronic Mechanical Neck Pain: A Randomized Clinical Trial.(Journal of Physical and Rehabilitation Medicine, 2021) Sánchez Jorge, Sandra; Oliva Pascual Vaca, Ángel; Rodríguez López, Elena Sonsoles; Valera Calero, Juan AntonioBackground Researchers investigated the effects of neuromuscular taping on different musculoskeletal conditions. Considering the demonstrated short-term effectiveness of neuromuscular taping for the management of shoulder pain, kinesiotaping may also be beneficial in reducing pain in patients with chronic mechanical neck pain. Objective To determine the immediate effects of neuromuscular taping on head position, neck pain and cervical range of motion in individuals with neck pain. Methods Sixty subjects with chronic neck pain were randomly assigned to 1 of 2 groups: the experimental group received neuromuscular taping on upper trapezius bilaterally (with tension) and the placebo group received a sham neuromuscular taping application (without tension). Visual analogue scale (VAS), craniocervical angle and cervical range of motion data were collected at baseline and immediately after the neuromuscular taping application. Results The group-by-time interaction for t-test was statistically significant for pain recorded by visual analogue scale (p< 0.001). Patients in the experimental group obtained a similar improvement in pain to those in the control group (p< 0.001). Conclusions Patients with mechanical neck pain who received and application of neuromuscular taping with proper tension or sham neuromuscular taping exhibited similar reductions in neck pain intensity, but not in cervical range of motion.Item Efectos analgésicos del ejercicio físico en pacientes con dolor crónico musculoesquelético durante el confinamiento por la pandemia COVID-19.(Archivos de Medicina del Deporte, 2020) Salom Moreno, Jaime; Sánchez Jorge, Sandra; Vicente Campos, Davinia; Berlanga, L. A.Introducción: El confinamiento vivido durante la pandemia del COVID-19 en España durante más de dos meses, podría afectar severamente a la condición y calidad de vida de los pacientes que sufren dolor crónico musculoesquelético. Teniendo en cuenta los efectos analgésicos que el ejercicio físico puede generar, gran parte de la población ha realizado ejercicio físico en sus domicilios como mecanismo del control del dolor, durante este periodo. Objetivo: El objetivo de este estudio fue conocer el tipo y la dosis de ejercicio físico realizado, así como la percepción de los pacientes en la reducción del dolor, durante el periodo de confinamiento por el COVID-19. Material y método: Se realizó una encuesta ad hoc a través de Google Forms a 86 pacientes para conocer su estado, el tipo de ejercicio que realizaron y la cantidad de ejercicio, así como si habían percibido una reducción de su dolor durante el periodo de confinamiento. Resultados: La intensidad de dolor disminuyó de forma significativa (p=0,001) cuando se hizo algún tipo de ejercicio físico. El ejercicio de fuerza fue elegido por el 51% de la población de forma exclusiva, y las frecuencias y el tiempo de sesión no fueron diferentes de forma significativa entre los sujetos que sintieron una reducción del dolor y los que no. Conclusión: Una programación de ejercicio físico de 4 días a la semana, durante al menos 50 minutos y con intensidades del 77% de FCmax de ejercicio aeróbico o de fuerza sería recomendable en un paciente con dolor crónico, como estrategia para la reducción del dolor. Los resultados de nuestro estudio no aconsejan, para pacientes con dolor crónico, sesiones de terapia combinada, independientemente de la localización primaria del dolor.Item Exercise Physiology at “Conversational Level” Is Not Impaired in Healthy Young Subjects Wearing Masks or Respirators.(Respiration, 2022) Sánchez Migallón, Violeta; Calvo Lobo, César; Sánchez Jorge, Sandra; Arce, Mónica; Vicente, Alejandra; Bello, Elena; Rodríguez Sanz, David; Becerro-de-Bengoa-Vallejo, Ricardo; López Chicharro, José; Vicente Campos, DaviniaObjective: The aim of this study was to evaluate the effects of the use of both surgical masks and FFP2 respirators on the inspiratory muscle strength, metabolic parameters, heart rate, subjective perceived exertion, and dyspnea perception, before and during 30 min stable load exercise at “conversational level”. Methods: A randomized cross-over study was carried out. Nineteen healthy adults completed 3 conditions (without a mask, with a surgical mask or an FFP2 respirator) during a 30-min steady-state test at the lactate threshold intensity. Inspiratory muscle strength was measured before and after the test, and metabolic parameters, heart rate, subjective perceived exertion, and dyspnea perception were collected at baseline, during, and after the test. Results: There was a significant reduction in inspiratory muscle strength after the 30-min test in all conditions (control: 6.26 mm Hg, p < 0.5; surgical mask: 8.55 mm Hg, p < 0.01; FFP2 respirator: 12.42 mm Hg, p < 0.001), but without significant differences between them (p = 0.283). Data showed a statistically significant effect for time, but did not show a statistically significant interaction between condition and time for heart rate (p = 0.674), oxygen saturation (p = 0.297), blood lactate level (p = 0.991), rating perceived exertion (p = 0.734) and dyspnea (p = 0.532) comparisons. Conclusions: The present study findings suggested that inspiratory muscle strength and physiological parameters during “conversational level” exercise were not impaired under wearing masks in healthy, nonsmoking young adults.