Physical Therapy, Sports Therapy and Rehabilitation, Complementary and Manual Therapy
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Scopus Publications
Scopus Publications
Asynchronous telerehabilitation in prehabilitation and postoperative recovery for colorectal cancer: A protocol for a randomized controlled trial José Manuel Burgos-Bragado, Carolina Jiménez-Sánchez, Natalia Brandín-de la Cruz, Beatriz Carpallo-Porcar, Lilian Le Roux-Ethève, Juan Luis Blas-Laina, Jorge Alamillo-Salas, Paola Gracia Gimeno, Sandra Calvo Plos One, 2026 Introduction Colorectal cancer (CRC) is a leading global malignancy, and surgery is frequently followed by complications, functional decline, and reduced quality of life. Multimodal prehabilitation and rehabilitation can improve physical recovery and psychosocial outcomes, but uptake is often limited by logistical and mobility barriers. Asynchronous telerehabilitation offers a flexible, patient - centered, and scalable approach; however, its effectiveness across the perioperative CRC pathway has not been rigorously evaluated. This trial will evaluate a multimodal asynchronous program delivered in prehabilitation and postoperative phases, against a booklet-based usual-care approach reflecting the pre-existing perioperative pathway in the study setting before trial initiation. Methods This single-blind, parallel-group randomized controlled trial will compare an asynchronous multimodal telerehabilitation program with a booklet-based usual-care program in adults scheduled for elective CRC resection. Fifty-six participants will be randomized 1:1 to the telerehabilitation group (HEFORA platform) or the usual-care control group. The intervention includes a 2-week prehabilitation phase and a 4-week postoperative rehabilitation phase. Assessments will be performed at five time points: baseline (pre-prehabilitation), post-prehabilitation (pre-surgery), post-surgery (pre-rehabilitation), post-rehabilitation, and 3-month follow-up. Outcomes The primary outcome is functional capacity, measured by the Six-Minute Walk Test distance. Secondary outcomes include muscle strength, body composition, pulmonary function, physical activity, sleep quality, psychosocial variables, health-related quality of life, treatment expectancy, usability, satisfaction, and adherence. Analyses will follow the intention-to-treat principle using longitudinal models and sensitivity analyses for missing data and adherence. Conclusions: This study will provide evidence on the role of asynchronous telerehabilitation in perioperative colorectal cancer care. Positive results could inform clinical guidelines, promote wider adoption of digital rehabilitation strategies, and support a more accessible, patient-centered, and cost-effective approach to oncologic recovery. Trial registration ClinicalTrials.gov identifier: NCT06593678 .
Effects of a level-based immersive virtual reality physical therapy program on static and dynamic balance in Parkinson's disease: Protocol for a randomized controlled trial Lorena Morcillo-Martínez, María Sanz-Mármol, Adriana Isabel Romanos-Navarrete, Sandra Calvo, Lilian Le Roux-Ethève, Laura Esteban-Repiso, Paula Córdova-Alegre, Carolina Jiménez-Sánchez, Aitor Garay-Sánchez, Natalia Brandín-de la Cruz Plos One, 2026 Background Parkinson’s disease (PD) is a neurodegenerative disorder characterized by postural instability, which significantly contributes to an increased risk of falls (occurring in 45–68% of persons with PD annually), leading to greater functional dependence, social isolation, and a significant decrease in quality of life. The aim of this randomized clinical trial is to evaluate the effects of an immersive virtual reality (IVR) intervention on static and dynamic balance, gait speed, functional mobility, lower limb strength, and quality of life in people with PD. Furthermore, the study will assess treatment adherence, participant satisfaction, as well as the potential occurrence of adverse effects associated with the application of IVR. Methods A 10-month, single-blind, two-arm randomized controlled trial will be conducted with participants aged 55–90 years diagnosed with PD and classified between stages 2.5 and 4 on the modified Hoehn and Yahr scale. Participants will be randomly assigned to one of two groups: an experimental group and a control group. The intervention will consist of an 8-session program. The first part of each session, common to both groups, will include a standardized strength training program. In the second part, the experimental group will receive a physical therapy balance program using IVR, while the control group will follow a usual physical therapy balance exercise program. Discussion This study will examine whether IVR can improve static and dynamic balance rehabilitation in Parkinson’s disease beyond usual physical therapy, addressing real-world motor and dual-task challenges. By providing enriched sensory input and adaptive tasks, the IVR seeks to optimize motor learning and functional mobility. Demonstrating safety and clinically meaningful improvements would support IVR as a scalable and engaging tool to reduce risk of falls and enhance quality of life in PD. Trial registration ClinicalTrials.gov NCT07274514
Study protocol for a mixed-methods pilot of a physiotherapy plus education program for inpatients with major depressive disorder: Feasibility and preliminary effects José Lesmes Poveda-López, Carolina Jiménez-Sánchez, Raquel Lafuente-Ureta, Bárbara Marco-Gómez, Ana Villagrasa-Cantín, Sara Pérez-Mansilla, Marta Guarch-Rubio, Juan Francisco Roy Plos One, 2025 Background Major depressive disorder is a mood disorder with significant psychological and physical symptoms that can lead to disability and other severe consequences. This disorder is influenced by both genetic and environmental factors, causing neurotransmitter imbalances and inflammation. Given mayor depressive disorder’s high prevalence and impact, it is crucial to implement a health promotion and intervention program aimed at this disorder. Investigating the feasibility of physical therapy, including therapeutic exercise and health education, compared to psychiatric and psychological approaches is an essential component of this program and of improving the quality of life for patients affected by mayor depressive disorder. Methods A concurrent nested mixed-methods study with quantitative dominance will be conducted. The quantitative study will be a quasi-experimental pilot study with a pre-post design. This study will additionally include a qualitative narrative design. Initial and post-intervention evaluations will include sociodemographic and clinical data. Quantitative data will be collected using the EQ-5D-3L, MADRS, NRS, GSE, and GCPC-UN-ESU questionnaires. These tools assess health status, depression severity, pain intensity, self-efficacy, and satisfaction levels. Qualitative data will be collected from focus groups with 6–8 participants. The question guide for patients will cover their experiences with their illness and intervention, while the guide for professionals will cover their perceptions of patient management and observed barriers and facilitators. All participants will receive the same evidence-based intervention over 3–6 weeks, with 2 weekly sessions of approximately 45 minutes each. Each session will consist of therapeutic exercise and health education to improve patients’ physical condition and self-management skills. Discussion This study aims to evaluate the feasibility and acceptability of a physiotherapy intervention program for MDD patients. It will also provide preliminary insights into the effects on quality of life, pain, and self-efficacy, which will inform the design of a future definitive trial. The findings from this research will provide valuable scientific insights and a basis for guiding health-care policymakers on the potential inclusion of physical therapy in clinical practice guidelines and standard hospital treatments for major depressive disorders. Clinical Trial registration NCT06983405.
Self-Assessment Tool in Soft Skills Learning During Clinical Placements in Physiotherapy Degree Programs: A Pilot Validation Study Rita María Galán-Díaz, Carolina Jiménez-Sánchez, Raquel Lafuente-Ureta, Natalia Brandín-de la Cruz, Jose Manuel Burgos-Bragado, Beatriz Alonso-Cortés Fradejas, Inmaculada Villa-Del-Pino, Manuel Gómez-Barrera Sustainability Switzerland, 2025 Physiotherapy is challenged to be a profession with competencies in humanized skills and aptitudes. The need to integrate the learning of sustainable soft skills and humanistic education into higher education curricula has recently been emphasized to improve the capabilities of future healthcare professionals. Our objective was to psychometrically evaluate the Invisible Care, Well-being, Security, and Autonomy (CIBISA) scale in the context of physiotherapy through a pilot study involving students undertaking a degree in physiotherapy. The Delphi method was used over two rounds, and a focus group was convened to achieve a consensus on the adaptation of the CIBISA nursing scale to assess physiotherapy (CIBISA-F). For the psychometric validation of the CIBISA-F scale, the data-collection instruments used were the adapted CIBISA-F scale and two more validated scales related to soft skills. The scales were answered by 25 students at three different times, twice before the start of the clinical placements and once after. The results showed high internal consistency (α = 0.911), adequate reliability according to a Brand–Altman plot, and an adequate construct validity and sensitivity in comparison to other tools. The results of the present study suggest that this version of the CIBISA-F scale is a useful and reliable tool for measuring humanization skills in healthcare and physiotherapy students during their clinical placements, ensuring high-quality education.
Perceptions and Experiences of a Multimodal Rehabilitation Program for People With Post-Acute COVID-19: A Qualitative Study Beatriz Carpallo‐Porcar, Sandra Calvo, Sara Pérez‐Palomares, Laura Blázquez‐Pérez, Natalia Brandín‐de la Cruz, Carolina Jiménez‐Sánchez Health Expectations, 2025 IntroductionHome‑based rehabilitation has emerged as a practical solution for post‑acute phase COVID‑19 recovery, but patient perspectives on the different modalities remain underexplored.ObjectiveTo explore participants' perceptions and experiences after a 12‑week multimodal rehabilitation program delivered via asynchronous telerehabilitation versus a booklet after discharge and to identify the preferred format.MethodsQualitative descriptive study with two face‑to‐face focus groups of post‐discharge COVID‐19 patients (n = 12; age range 41–75 years; 50% female; with fatigue > 4 on the Fatigue Severity Scale) that included participants from each intervention arm of a randomised pilot study. Semi‑structured interviews to determine patients' perceptions and experiences were recorded, transcribed verbatim and coded independently by two researchers using inductive thematic analysis.ResultsThree overarching themes emerged from the analysis: (1) Facilitators for engagement and adherence: Innovative digital tools and personalised guidance foster active participation by providing flexible access and systematic progress monitoring; (2) Barriers to sustained participation: Technological issues, physical limitations and fluctuating motivation serve as critical impediments, underscoring the potential benefits of hybrid intervention models; and (3) Therapeutic alliance as support: A robust, individualised therapeutic relationship enhances patient confidence and self‐management, ultimately contributing to sustained empowerment and recovery.ConclusionsA multimodal home‐based rehabilitation program with monitoring and personalisation by the physiotherapist is rated positively by post‐acute COVID‐19 patients, with asynchronous telerehabilitation emerging as the preferred method. Future research should investigate long‑term adherence, clinical efficacy and scalability.Clinical Trial RegistrationClinialtrials.gov #NCT04794036.Patient or Public ContributionPost‐acute COVID‐19 patients contributed to the study by actively participating in its development, specifically through describing their experiences as part of a multimodal rehabilitation program. There was no additional participation or contribution from the public to the research.
Effectiveness of Electrical Muscle Elongation and Proprioceptive Neuromuscular Facilitation Programs on Muscle Flexibility and Stiffness in Young Adults with Functional Hamstring Disorder: A Randomized Clinical Trial with 4-Week Follow-Up Carolina Jiménez-Sánchez, Rocío Fortún-Rabadán, Beatriz Carpallo-Porcar, Paula Cordova-Alegre, Luis Espejo-Antúnez, María Ortiz-Lucas Life, 2025 Background: Adequate hamstring flexibility is crucial for musculoskeletal health as increased muscle tone can lead to stretch-type injuries, muscle weakness, dysfunctional neuromuscular control, postural changes, and lower back pain. The aim was to compare the effectiveness of a program based on Electrical Muscle Elongation (EME), Proprioceptive Neuromuscular Facilitation (PNF), and no intervention in improving flexibility and viscoelastic properties of hamstring and quadriceps muscles in active young adults with functional hamstring disorder (type 2B according to the Munich Consensus). Methods: Sixty-five participants (45 male, 20 female) were randomly assigned to three groups: the EME group (n = 21) received a simultaneous combination of interferential current and stretching, the PNF group (n = 22) underwent active stretching, and the Control group (n = 22) received no intervention. Hamstring and quadricep flexibility and muscle stiffness were measured in both limbs at baseline, post-intervention, and at the 4-week follow-up. Results: The EME group showed significant improvements in hamstring flexibility in the left limb compared to the Control group and in some myotonometric variables of the quadriceps muscle compared to the PNF and Control groups (p < 0.05). Within-groups differences indicated higher improvements in the EME group. Conclusions: This study suggests that EME may offer greater benefits than PNF stretching in young adults with functional hamstring disorder.
ARACOV-02. Specialized nutritional intervention and telerehabilitation in patients with long COVID: Protocol of a randomized controlled trial Beatriz Carpallo-Porcar, Carolina Jiménez-Sánchez, Sandra Calvo, Pilar Irún, Elena Kolesnyk-Sumskaya, Ana Isabel Aller-Blanco, Esther del Corral Beamonte Plos One, 2025 Background It is estimated that at least 10% of the population infected with SARS-CoV-2 develop Post COVID Condition, which is characterized by a diverse array of symptoms including dyspnea, fatigue, anxiety, depression, and deterioration in quality of life. The SARS-CoV-2 virus can trigger an excessive immune response, characterized by the release of pro-inflammatory cytokines including IL-6, IL-1, TNFα and reactive oxygen species. Specialized Pro Resolving Mediators (SPMs) (17-HAD, 14-HAD and 18_HEPE) that could be useful in Post COVID Condition modulating the inflammatory response. The objective is to determine the change in quality of life, inflammatory profile, functional capacity and emotional variables in a group taking a nutritional supplement (SPMs) plus a telerehabilitation programme. Methods ARACOV-2 study is a double-blind, parallel-group, randomized control trial with two parallel interventions: Nutritional supplement and telerehabilitation vs placebo supplement and telerehabilitation. The primary endpoint will be quality of life (EQ-5L-5D). The intervention will last 12 weeks with a daily intake of omega-3 or placebo and a daily supervised rehabilitation programme using telerehabilitation. Discussion This study suggests that SPMs supplementation combined with telerehabilitation may improve inflammation and symptoms like fatigue in Post COVID Condition patients. Both interventions have anti-inflammatory potential, and their combined use could enhance physical and mental health outcomes. This approach offers a promising strategy for managing Post COVID Condition symptoms. Trial registration ClinicalTrials.gov NCT06063031
Effectiveness of physiotherapy techniques on depressive symptoms in older adults: a systematic review José Lesmes Poveda-López, Carolina Jiménez-Sánchez, Juan Francisco Roy, Raquel Lafuente-Ureta, Ana Aguilera-Gonzalo Frontiers in Public Health, 2025 IntroductionThe older adult population suffers from a high prevalence of depression, representing an increasing burden on healthcare systems. In this context, this systematic review evaluated the effectiveness of physiotherapy for the management of depressive symptoms in this population. The population aged 65 and over is increasing in developed countries such as Spain, currently accounting for 19.09% and projected to reach 25.2% within the next decade. Depression is one of the most prevalent mental health conditions in this group, affecting 5% of community-dwelling individuals and 25% in institutional settings, significantly reducing quality of life and increasing the risk of dementia. While the pharmacological and psychotherapeutic treatments are standard, they present adverse effects and limitations in this population, prompting the exploration of physiotherapy as a non-pharmacological alternative.ObjectiveTo analyze the scientific evidence regarding the effectiveness of combining conventional treatments with physiotherapy techniques for symptomatic improvement in older patients with depression, and to identify the most effective physiotherapy technique, when combined with conventional treatment, for depressive symptoms in older adults.MethodsWe conducted a systematic review following PRISMA guidelines, and we performed searches in PubMed, Web of Science (WOS), Scopus and Cochrane Library databases. Study quality and risk of bias were assessed using the Cochrane Collaboration’s tool.ResultsEight randomized controlled trials, encompassing a total of 1,368 older participants diagnosed with depression or depressive symptoms who received physiotherapy, were included. The findings indicate that physiotherapy techniques, particularly therapeutic exercise, in combination with conventional treatments, may improve depressive symptoms in this population.ConclusionAlthough we observed positive trends in the effectiveness of physiotherapy for depression in older adults, further research is required to validate its clinical efficacy and inform evidence-based treatment guidelines.Systematic review registrationhttps://www.crd.york.ac.uk/PROSPERO/view/CRD420251079161.
Benefits of musculoskeletal health promotion in school communities through service-learning: a mixed-method approach Sandra Calvo, Rocío Fortún-Rabadán, Sara Pérez-Palomares, Beatriz Carpallo-Porcar, Raquel Lafuente-Ureta, Carolina Jiménez-Sánchez Frontiers in Public Health, 2025 BackgroundService-learning (S-L) is an educational method that enhances social and civic engagement among health science students, addressing unmet community needs. Musculoskeletal disorders (MSKD) represent a public health issue with increasing prevalence among school-aged population as reported by at least 1 on 5 children. Prevention programs for MSKD in schools are scarce, although evidence supports the efficacy of health education provided by physical therapists. This study aimed to evaluate the impact of a musculoskeletal health promotion program through S-L on school students, teachers, and physical therapy students.MethodsA mixed-methods approach was used. A quasi-experimental design assessed the learning and satisfaction of school students and teachers using pre-and post-intervention questionnaires. Additionally, qualitative data from reflective diaries of fourth-year physical therapy students were analyzed to capture their experiences. The intervention was conducted in 10 schools in Spain over two academic years, targeting children aged 10–14 and their teachers.ResultsA total of 1,051 school students and 32 teachers participated. Pre-post evaluations revealed significant learnings on MSKD prevention and body awareness in both groups (p &lt; 0.05), highlighting the increase in knowledge about MSKD prevention and self-treatment for school students and on MSKD derived from inadequate postures for schoolteachers. Satisfaction was high, with students and teachers rating the program 4.4/5. Teachers highlighted the value of training for their professional practice, while students appreciated learning about self-care. Physical therapy students were 4 and reflected on their motivation for the project, learning experiences, as well as positive and negative aspects of the service.DiscussionThe S-L community-based intervention effectively increased awareness of musculoskeletal health and self-management skills. The peer learning environment and participatory approach encouraged engagement and knowledge retention in both students and teachers.ConclusionS-L is a valuable strategy for promoting musculoskeletal health in schools while improving health education skills among the future physical therapists through experiential learning.
Improvements of depression, anxiety, stress, and social support through a telerehabilitation system in discharged COVID-19 patients: a randomized controlled pilot study Beatriz Carpallo Porcar, Sandra Calvo, Irene Liñares Varela, Laura Bafaluy Franch, Natalia Brandín de la Cruz, Manuel Gómez Barrera, Carolina Jiménez-Sánchez Psychology Health and Medicine, 2025 INTRODUCTION Post-acute COVID-19 patients who were discharged from hospitals during the epidemic faced significant challenges, not only physical sequelae, but also psychological distress, anxiety, and depression. It is already known that continued exercise improves psychosocial components, but few studies have explored the impact of multimodal rehabilitation programs, including therapeutic education, in this type of patient. There are no studies that explore the application of these programs through asynchronous telerehabilitation, which would open up new therapeutic windows. METHODS This pilot single-blinded randomized controlled trial included 35 post-discharge COVID-19 patients allocated to two intervention arms: an asynchronous telerehabilitation group (ATG) and a booklet-based rehabilitation group (BRG). The aim was to analyze the preliminary changes in depression, anxiety, stress, and social support comparing both groups. RESULTS The ATG exhibited statistically significant reductions in depression (p = 0.048) and stress (p = 0.033) compared to the BRG after intervention. While both groups showed improvements in psychosocial variables, the ATG demonstrated consistent lower depression levels at 3- and 6-month follow-ups (p = 0.010, p = 0.036 respectively) and notably higher social support at 3- and 6-month follow-ups (p = 0.038, p = 0.028 respectively). DISCUSSION This pilot study suggests that a multimodal rehabilitation program using asynchronous telerehabilitation provides substantial benefits in terms of alleviating psychological distress and improving social support in discharged COVID-19 patients. These data will enable for larger studies to confirm these results.
Osteoarthrosis: Is It Just a Local Disease? Javier Belsué, Sandra Calvo, Carolina Jiménez-Sánchez, Sara Pérez-Palomares, Pablo Herrero, Pablo Bellosta-López Topics in Geriatric Rehabilitation, 2021
