Examinando por Autor "Florencio, Lidiane L."

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Clustering analysis reveals different profiles associating long-term post-COVID symptoms, COVID-19 symptoms at hospital admission and previous medical co-morbidities in previously hospitalized COVID-19 survivors
(Springer, 2022) Fernández-de-las-Peñas, César; Martín-Guerrero, José D.; Florencio, Lidiane L.; Navarro-Pardo, Esperanza; Rodríguez-Jiménez, Jorge; Torres-Macho, Juan; Pellicer-Valero, Oscar J.
Purpose To identify subgroups of COVID-19 survivors exhibiting long-term post-COVID symptoms according to clinical/ hospitalization data by using cluster analysis in order to foresee the illness progress and facilitate subsequent prognosis. Methods Age, gender, height, weight, pre-existing medical comorbidities, Internal Care Unit (ICU) admission, days at hospital, and presence of COVID-19 symptoms at hospital admission were collected from hospital records in a sample of patients recovered from COVID-19 at fve hospitals in Madrid (Spain). A predefned list of post-COVID symptoms was systematically assessed a mean of 8.4 months (SD 15.5) after hospital discharge. Anxiety/depressive levels and sleep quality were assessed with the Hospital Anxiety and Depression Scale and Pittsburgh Sleep Quality Index, respectively. Cluster analysis was used to identify groupings of COVID-19 patients without introducing any previous assumptions, yielding three diferent clusters associating post-COVID symptoms with acute COVID-19 symptoms at hospital admission. Results Cluster 2 grouped subjects with lower prevalence of medical co-morbidities, lower number of COVID-19 symptoms at hospital admission, lower number of post-COVID symptoms, and almost no limitations with daily living activities when compared to the others. In contrast, individuals in cluster 0 and 1 exhibited higher number of pre-existing medical co-morbidities, higher number of COVID-19 symptoms at hospital admission, higher number of long-term post-COVID symptoms (particularly fatigue, dyspnea and pain), more limitations on daily living activities, higher anxiety and depressive levels, and worse sleep quality than those in cluster 2. Conclusions The identifed subgrouping may refect diferent mechanisms which should be considered in therapeutic interventions.
The cervical spine in tension type headache
(Elsevier, 2023) Fernández-de-las-Peñas, César; Cook, Chad; Cleland, Joshua A.; Florencio, Lidiane L.
Introduction: The concept that headaches may originate in the cervical spine has been discussed over decades and is still a matter of debate. The cervical spine has been traditionally linked to cervicogenic headache; however, current evidence supports the presence of cervical musculoskeletal dysfunctions also in tension-type headache. Purpose: This position paper discusses the most updated clinical and evidence-based data about the cervical spine in tension-type headache. Implications: Subjects with tension-type headache exhibit concomitant neck pain, cervical spine sensitivity, forward head posture, limited cervical range of motion, positive flexion-rotation test and also cervical motor control disturbances. In addition, the referred pain elicited by manual examination of the upper cervical joints and muscle trigger points reproduces the pain pattern in tension-type headache. Current data supports that the cervical spine can be also involved in tension-type headache, and not just in cervicogenic headache. Several physical therapies including upper cervical spine mobilization or manipulation, soft tissue interventions (including dry needling) and exercises targeting the cervical spine are proposed for managing tension-type headache; however, the effectiveness of these interventions depends on a proper clinical reasoning since not all will be equally effective for all individuals with tension-type headache. Based on current evidence, we propose to use the terms cervical “component” and cervical “source” when discussing about headache. In such a scenario, in cervicogenic headache the neck can be the cause (source) of the headache whereas in tension-type headache the neck will have a component on the pain pattern, but it will be not the cause since it is a primary headache.