Clinical trials

Chronic post-stroke hemiplegia frequently results in persistent motor deficits, impaired balance, and reduced quality of life. Conventional physical therapy is fundamental for functional recovery; however, motor improvement often plateaus during the chronic phase. Repetitive transcranial magnetic stimulation (rTMS) is a non-invasive neuromodulation technique that has shown potential to enhance motor recovery by modulating cortical excitability and promoting neuroplasticity. This case series aims to investigate the effects of a combined protocol of repetitive transcranial magnetic stimulation and conventional physical therapy on motor function, balance, and quality of life in individuals with chronic post-stroke hemiplegia. Participants will undergo rTMS applied to the motor cortex in conjunction with a structured physical therapy program. Clinical outcomes will be assessed before and after the intervention to explore feasibility, safety, and potential functional benefits of the combined approach.

The goal of this clinical trial is to evaluate the impact of various passive post-exercise recovery techniques on professional athletes. The main questions it aims to answer are: Do passive recovery modalities significantly improve muscle oxygenation and tissue temperature immediately following high-intensity effort? Which specific technique is most effective in reducing perceived pain, measured by the pressure pain threshold, and restoring muscle strength? Researchers will compare six different therapeutic interventions-Transfer of Energy Capacitive and Resistive therapy, manual massage, intermittent negative pressure therapy, extracorporeal shockwave therapy, percussion therapy, and pneumatic pressotherapy-to determine which provides a superior immediate physiological and functional recovery effect. Participants will: Perform a high-intensity physical effort designed to induce peripheral fatigue. Be randomly assigned to receive one of the six recovery protocols. Undergo objective measurements immediately after the intervention, including near-infrared spectroscopy to assess muscle oxygen saturation, tissue thermography, algometry, and dynamometry.

This study investigates whether focused Extracorporeal Shockwave Therapy (fESWT) helps people with chronic heel pain, commonly known as plantar fasciitis. Many patients suffer from this condition for more than six months without relief. The study compares two groups: one receiving fESWT treatment plus a specific exercise program, and a "wait-list" group that only performs the exercises at first. The shockwave treatment uses precise sound waves targeted at the painful area to stimulate the body's natural healing process. Researchers will measure if the treatment reduces pain and improves the patient's ability to walk and perform daily activities. Additionally, ultrasound will be used to see if the thickness of the plantar fascia (the tissue under the foot) decreases and returns to a healthier state. The goal is to confirm if fESWT provides a faster and more effective recovery than exercise alone.

Respiratory muscles play a fundamental role in sports performance. Fatigue of these muscles induces changes in maximal inspiratory pressure and autonomic nervous system activity, thereby compromising the athlete's recovery process. The primary aim of this study is to evaluate the specific effects of different inspiratory muscle activation modalities on post-exercise recovery in professional male football players. The study seeks to determine which of the three modalities-bilateral phrenic nerve electrical stimulation, a threshold loading device protocol, or inactivity-provides greater benefits for recovery. The effectiveness of these interventions will be assessed using two key outcome variables: maximal inspiratory pressure (MIP) and heart rate variability (HRV). This study is designed as a randomized clinical trial (RCT) in which participants will be allocated into three intervention groups: a bilateral phrenic nerve electrical stimulation group (EG1), in which involuntary diaphragmatic contractions will be induced using an electrotherapy device with current applied to the phrenic nerves; a threshold device group (EG2), in which participants will perform breathing against submaximal inspiratory loads equivalent to 40% of their MIP; and a control group (CG), which will remain seated for a period equivalent to the duration of the other interventions. Group allocation will be ensured through randomization using Microsoft Excel. Regarding statistical analysis, data normality will be assessed using the Shapiro-Wilk test. Comparisons of quantitative variables will be performed using Student's t test when normality assumptions are met, or the Mann-Whitney U test otherwise. A p value \< 0.05 will be considered statistically significant.

This randomized controlled trial investigates the acute effects of inspiratory muscle warm-up and fatigue on diaphragmatic function in professional basketball players. Using ultrasound imaging and maximal inspiratory pressure (PIM) assessment, the study evaluates changes in diaphragmatic thickness and respiratory strength before and after specific inspiratory muscle loading protocols. Findings aim to clarify the short-term impact of these interventions on diaphragmatic recovery capacity, with potential implications for respiratory training, performance enhancement, and injury prevention strategies in elite athletic populations.

Respiratory muscle training represents an effective method increasingly utilized in both sports and healthcare domains, employing various devices, among which threshold devices are prominent. The aim of this study is to determine the relationship between inspiratory muscle fatigue or warm-up and muscular strength in upper and lower limbs, in sedentary older adults, as well as the association between such fatigue and other variables, including maximal inspiratory pressure, diaphragmatic ultrasonography, functionality and handgrip strength. According to our hypothesis, the execution of a protocol inducing inspiratory muscle fatigue or activation in sedentary older adults could influence muscular strength, respiratory function and exercise capacity. In this study, subjects will be divided into three groups: the fatigue group , the activation group and the control group. Measurements of variables, such as maximal inspiratory pressure, diaphragmatic strength (ultrasound image) and functional capacity, will be conducted.

This randomized controlled trial explores the impact of a combined transcranial and peripheral electromagnetic stimulation over the potential correlation between psychological well-being and recovery outcomes of young athletes experiencing Delayed Onset Muscle Soreness.

The supply of oxygen is essential for energy production, recovery from efforts, and human life. Intermittent Hypoxia-Hyperoxia Exposure (IHHE) is a novel technique in which the subject is exposed to a respiratory environment with reduced oxygen fraction, controlled through a specific software, using a facial mask and a hypoxic generation device. The objective of this study is to determine if there is a relationship between intermittent hypoxia-hyperoxia exposure and cardiorespiratory condition, blood pressure, and arterial oxygen saturation. According to our hypothesis, acute IHHE in elderly adults may influence cardiorespiratory condition, blood pressure, and arterial oxygen saturation. The study will be conducted as a randomized clinical trial. The subjects will be divided into two groups: the experimental group will undergo an IHHE session, breathing air with an oxygen concentration (FiO2) ranging from 10-14% for 1-5 minutes, with 1-3 minutes of rest in hyperoxia (FiO2 30-40%) for a total of 4-8 cycles, based on their acute response to hypoxia. The placebo group will undergo a 5-cycle protocol with an FiO2 of 21%.

The supply of oxygen is essential for energy production, recovery from efforts, and human life. Intermittent Hypoxia-Hyperoxia Exposure (IHHE) is a novel technique in which the subject is exposed to a respiratory environment with reduced oxygen fraction, controlled through a specific software, using a facial mask and a hypoxic generation device. The objective of this study is to determine if there is a relationship between intermittent hypoxia-hyperoxia exposure and cardiorespiratory condition, blood pressure, and arterial oxygen saturation. According to our hypothesis, acute IHHE in elderly adults may influence cardiorespiratory condition, inflammatory biomarkers, blood pressure, and arterial oxygen saturation. The study will be conducted as a randomized clinical trial. The subjects will be divided into two groups: the experimental group will undergo an IHHE session, breathing air with an oxygen concentration (FiO2) ranging from 10-14% for 1-5 minutes, with 1-3 minutes of rest in hyperoxia (FiO2 30-40%) for a total of 4-8 cycles, based on their acute response to hypoxia. The sham group will undergo a 5-cycle protocol with an FiO2 of 21%. Both groups will follow a 6-week protocol with three weekly sessions (Monday, Wednesday, and Friday).

Hospitalization due to acute illness often leads to a decline in physical function and quality of life, which significantly impacts the emotional well-being of patients, their families, and primary caregivers. Emotional well-being is a critical aspect of overall health, enabling individuals to cope with and adapt to health challenges. Addressing this dimension within the hospital setting is vital to improving patient outcomes, particularly from a biopsychosocial perspective that considers physical, psychological, and social factors. This study aims to evaluate the effectiveness of physiotherapy interventions in enhancing the emotional well-being of hospitalized patients. While early physiotherapy is well-documented for its benefits in preventing complications and improving physical recovery, there is limited research demonstrating its impact on emotional well-being. Furthermore, data on the effects of prolonged hospitalization on the biopsychosocial health of patients is lacking. Conducted at the Hospital Universitario de la Princesa (Madrid, Spain), a high-complexity hospital, this project will assess the role of physiotherapy not only in physical recovery but also in fostering emotional support. The intervention is designed to provide both therapeutic and emotional benefits, incorporating moments of relaxation and leisure into the treatment sessions. The study aligns with the growing global trend towards person-centered care and the humanization of healthcare. This approach emphasizes a more holistic and personalized patient experience, where physiotherapy contributes to the overall health and well-being of the patient, addressing their physical and emotional needs.

Multiple Sclerosis (MS) is a chronic, autoimmune, inflammatory, and degenerative neurological disorder that affects the central nervous system. Symptoms vary widely depending on the areas impacted and may include fatigue, vision issues, speech difficulties, tremors, limb weakness, loss of sensation, vertigo, coordination problems, and bladder and bowel dysfunction. Among these, lower urinary tract symptoms are particularly common and significantly impact the quality of life for MS patients. Neurogenic overactive bladder (NOAB) is a prevalent urinary issue in individuals with MS. Treatment options for NOAB include behavioral therapy, β-3 agonists, anticholinergic agents, posterior tibial nerve neuromodulation (PTNM), botulinum toxin injections, sacral root neurostimulation, and surgical interventions. Repetitive transcranial magnetic stimulation (rTMS) is a non-invasive brain stimulation technique that may improve bladder function by modulating neural activity through an electromagnetic coil placed on the scalp. In contrast, posterior tibial nerve neuromodulation (PTNM) involves electrical stimulation of the spinal cord roots, primarily the S3 segment, to enhance bladder function. Despite promising evidence, rTMS and PTNM are not yet widely recommended in global guidelines due to the limited number of studies, many of which are case reports. The growing prevalence of overactive bladder underscores the need for effective, non-invasive treatments to improve management and optimize current protocols. This study aims to evaluate and compare the efficacy of rTMS and tibial nerve stimulation in managing neurogenic overactive bladder in MS patients at Hospital Universitario de la Princesa. The primary objective is to determine whether rTMS is superior, equivalent, or inferior to tibial nerve stimulation in treating NOAB. The study's hypothesis is that the efficacy of transcranial magnetic stimulation will differ from that of tibial nerve stimulation in managing NOAB in MS patients at Hospital Universitario de la Princesa, with a focus on assessing whether rTMS offers superior, equivalent, or inferior outcomes compared to tibial nerve stimulation. This investigation seeks to provide valuable insights into the effectiveness of these treatment modalities.