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Medina i Mirapeix, Francesc

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Medina i Mirapeix, Francesc
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Universidad de Murcia. Departamento de Fisioterapia
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    Stability and predictors of poor 6-min walking test performance over 2 years in patients with COPD
    (MDPI, 2020-04-18) Sánchez Martínez, Mª Piedad; Bernabeu Mora, Roberto; Martínez González, Mariano; Gacto Sánchez, Mariano Luis; Martín San Agustín, Rodrigo; Medina i Mirapeix, Francesc; Fisioterapia; Facultad de Medicina
    Poor performance in the 6-min walk test (6MWT < 350 m) is an important prognostic indicator of mortality and risk of exacerbations in patients with chronic obstructive pulmonary disease (COPD). Little is known about the stability of this state over time and what factors might predict a poor 6MWT performance. To determine the stability of 6MWT performance over a 2-year period in COPD patients participating in annual medical follow-up visits, and to assess the ability of several clinical, pulmonary, and non-pulmonary factors to predict poor 6MWT performance, we prospectively included 137 patients with stable COPD (mean age, 66.9 8.3 years). The 6MWT was scored at baseline and 2-year follow-up. To evaluate clinical, pulmonary, and non-pulmonary variables as potential predictors of poor 6MWT performance, we used multiple logistic regression models adjusted for age, sex, weight, height, and 6MWT performance at baseline. Poor 6MWT performance was stable over 2 years for 67.4% of patients. Predictors of poor 6MWT performance included a five-repetition sit-to-stand test score 2 (OR, 3.01; 95% CI, 1.22–7.42), the percentage of mobility activities with limitations (OR, 1.03; 95% CI, 1.00–1.07), and poor 6MWT performance at baseline (OR, 4.64; 95% CI, 1.88–11.43). Poor 6MWT performance status was stable for the majority of COPD patients. Lower scores on the five-repetition sit-to-stand test and a higher number of mobility activities with limitations were relevant predictors of poor 6MWT performance over 2 years. Prognostic models based on these non-pulmonary factors can provide non-inferior discriminative ability in comparison with prognostic models based on only pulmonary factors.
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    Identifying COPD patients with poor health status and low exercise tolerance through the five-repetition sit-to-stand test and modified Medical Research Council Dyspnea Score
    (Elsevier, 2024-07-01) Bernabeu Mora, Roberto; Oliveira Sousa, Silvana Loana de; Medina i Mirapeix, Francesc; Gacto Sánchez, Mariano Luis; Fisioterapia
    Background: The objective of this study was to determine whether the concomitant presence of poor health status (COPD Assessment Test, CAT ≥ 10 points) and low exercise tolerance (6-Minute Walking Test, 6MWT < 350 m) is associated with worse clinical characteristics in patients with COPD. In addition, we aimed to develop a readily applicable diagnostic model to discriminate COPD patients with these conditions. Methods: A cross-sectional multicenter study involving 208 stable COPD patients (FEV1/FVC < 0.7, smoking history of at least 10 pack-years, and chronic respiratory symptoms) was carried out. The outcome measures were the 6MWT, CAT score, 5-repetition sit-to-stand test (5STS) and modified Medical Research Council Dyspnea Scale (mMRC). Patients were categorized into three groups: no condition (6MWT ≥ 350 m and CAT < 10 points), one condition (6MWT < 350 m or CAT ≥ 10 points), and both conditions (6MWT < 350 m and CAT ≥ 10 points). Results: A total of 26 patients (12,5%) presented both conditions. These patients experienced a higher degree of dyspnea (p = 0.001), smoking pack-years (p = 0.011), severe obstruction (p = 0.006), and time on 5STS (p = 0.001). The probability of having both conditions directly increased with the time spent on the 5STS (β=0.188; p = 0.010) and the degree of dyspnea (β=1.920; p < 0.001) (R2=0.413). The scoring system, using the 5STS and dyspnea as surrogate measures, demonstrated adequate calibration between the predicted and observed risk (linear R2=0.852). Conclusions: COPD patients with concurrent conditions have worse clinical status. The diagnostic model developed to discriminate these patients shows good internal validation.
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    Galvanic current activates the NLRP3 inflammasome to promote Type I collagen production in tendon
    (eLife Sciences Publications, 2022-02-24) Peñin Franch, Alejandro; García Vidal, José Antonio; Escolar Reina, Pilar; Martínez Ojeda, Rosa M. ; Gómez, Ana I.; Bueno García, Juan Manuel; Minaya-Muñoz, Francisco; Valera-Garrido, Fermín; Escolar Reina, Pilar; Bueno García, Juan Manuel; Medina i Mirapeix, Francesc; Martínez Cáceres, Carlos Manuel; Fisioterapia
    The NLRP3 inflammasome coordinates inflammation in response to different pathogen- and damage-associated molecular patterns, being implicated in different infectious, chronic inflammatory, metabolic and degenerative diseases. In chronic tendinopathic lesions, different non-resolving mechanisms produce a degenerative condition that impairs tissue healing and which therefore complicates their clinical management. Percutaneous needle electrolysis consists of the application of a galvanic current and is an emerging treatment for tendinopathies. In the present study, we found that galvanic current activates the NLRP3 inflammasome and induces an inflammatory response that promotes a collagen-mediated regeneration of the tendon in mice. This study establishes the molecular mechanism of percutaneous electrolysis that can be used to treat chronic lesions and describes the beneficial effects of an induced inflammasome-related response.
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    Mobility limitations related to reduced pulmonary function amongaging people with chronic obstructive pulmonary disease
    (Plos One, 2018-05-01) Medina i Mirapeix, Francesc; Bernabeu Mora, Roberto; Sánchez Martínez, Mª Piedad; Montilla Herrador, Joaquina; Myriam Bernabeu Mora; Escolar Reina, Pilar; Fisioterapia; Facultades de la UMU::Facultad de Medicina
    Background Chronic obstructive pulmonary disease (COPD) is a major cause of disability. We aimed to analyse the impact of reduced pulmonary function on non-respiratory impairments and mobility activity limitations in an elderly population with COPD and to elucidate which spe cific limitations on mobility are related to reduced pulmonary function Methods Cross-sectional study of 110 patients with COPD, recruited from public and university hospi tal. The effect of impaired pulmonary function on the risk of non-respiratory impairments and mobility limitations was analysed using validated measures, including: the 6-Minute Walk Test (6MWT), skeletal muscle strength, the Short Physical Performance Battery (SPPB), andself-reported mobility questionnaire. Multivariate analysis was used to control for con founders such as age, sex, height, education, and cigarette smoking. Results Greater impairment of pulmonary function was associated with less distance walked during the 6MWT,poorerSPPBscores,andgreater risk of self-reported mobility limitations (p<0.05). Lower forced expiratory volume in 1 s was also associated with a greater risk of limitations in carrying items under 10 pounds (4.54 kg), walking alone up and down a flight of stairs, and walking two or three neighbourhood blocks. There was no clear statistical rela tionship between pulmonary function impairment and skeletal muscle strength. Conclusions Impaired pulmonary function was associated with the 6MWT score and limitations on perfor mance-based and self-reported mobility activities, but not with skeletal muscle strength amongelderly COPDpatients
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