Juan Carlos Sánchez-García

Universidad de Granada

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Raquel Rodríguez-Blanque

Universidad de Granada

Jonathan Cortés‐Martín

Universidad de Granada

María José Aguilar Cordero

Universidad de Granada

Beatriz Piqueras-Sola

Junta de Andalucía

Lourdes Díaz‐Rodríguez

Universidad de Granada

Antonio Manuel Sánchez-López

Hospital Universitario Puerta de Hierro Majadahonda

María José Menor-Rodríguez

Instituto de Investigación Sanitaria de Santiago

Ana Eugenia Marín-Jiménez

Universidad de Granada

Elena Mellado-García

Junta de Andalucía

María Isabel Tovar-Gálvez

Universidad de Granada

Cooperative Institutions

Universidad de Granada

Junta de Andalucía

Instituto de Investigación Biosanitaria de Granada

Hospital Universitario Virgen de las Nieves

Instituto Politécnico Nacional

Andalusian Health Service

Universidad de Málaga

Instituto de Salud Carlos III

Hospital Costa del Sol

Universidad de la República

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Effects of Hydrotherapy on the Management of Childbirth and Its Outcomes—A Retrospective Cohort Study

Nursing Reports (2024)

Elena Mellado-García Lourdes Díaz‐Rodríguez Jonathan Cortés‐Martín Juan Carlos Sánchez-García Beatriz Piqueras-Sola

The use of hydrotherapy during childbirth has gained relevance due to the demand for natural childbirth and greater respect for the woman’s choice. Studies have shown benefits such as less use of epidural analgesia, increased ability to cope with pain, shorter labor, and a better overall birth experience. Objective: The main objective of this study was to generate further evidence on maternal and birth outcomes associated with the use of hydrotherapy during labor, specifically aiming to describe the effects of water immersion during all stages of labor (first, second, and third) on women. Methodology: A retrospective cohort study was carried out on a random sample of women who gave birth at the Costa del Sol Hospital between January 2010 and December 2020. The calculated sample size was 377 women and the data were extracted from their partograms. After data extraction, two groups were formed: one group used hydrotherapy during childbirth (n = 124), while the other group included women who did not use hydrotherapy during the childbirth process (n = 253). Results: The results highlight significant differences in pain perception, analgesia use, types of labor, and delivery times between the two groups. Women who did not use hydrotherapy reported higher pain perception, with a median (IQR) of 8 (7–9) on a numerical scale, compared to a median (IQR) of 6 (5–7) for the hydrotherapy group. Furthermore, the group without hydrotherapy required epidural analgesia in 40% of cases, while in the hydrotherapy group, it was only necessary in 20%. In terms of the type of delivery, the hydrotherapy group had more spontaneous vaginal deliveries compared to the non-hydrotherapy group, which had more operative vaginal deliveries. The overall duration of labor was longer in the hydrotherapy group, especially in women who arrived at the hospital late in labor. Conclusions: Hydrotherapy is associated with a longer time to delivery. Women with a higher pain tolerance tend to opt for hydrotherapy instead of epidural analgesia.

Hydrotherapy

10.3390/nursrep14020095

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Citations (2)

P-177 Early onset colorectal cancer outcomes in a public Uruguayan cancer centre

Annals of Oncology (2021)

Santiago Fontes Ana Eugenia Marín-Jiménez Megan Berry Juan Carlos Sánchez-García Guillermo Yanowsky Reyes

10.1016/j.annonc.2021.05.232

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Systematic Reviews and Synthesis without Meta-Analysis on Hydrotherapy for Pain Control in Labor

Healthcare (2024)

Elena Mellado-García Lourdes Díaz‐Rodríguez Jonathan Cortés‐Martín Juan Carlos Sánchez-García Beatriz Piqueras-Sola

Background: Although there is scientific evidence regarding the use of water immersion during labor, this evidence is primarily focused on the first stage of labor. There is limited scientific evidence on water immersion during the second stage of labor. Objective: The objective of this study was to conduct a comprehensive systematic review and synthesis of contemporary evidence related to water birth, with a specific focus on the second stage of labor. Methods: A systematic review of the scientific literature published between January 2018 and October 2023 was carried out. A synthesis of the results was conducted following the Synthesis without Meta-Analysis (SWiM) guidelines. PubMed, Scopus, and the Cochrane Library were utilized as information sources. The search strategy was designed using the keywords “immersion” and “parturition”, along with their relevant synonyms. Inclusion criteria encompassed studies employing randomized controlled trials (RCTs), systematic reviews, and quantitative and qualitative approaches focusing on pregnant women undergoing water immersion at any stage of the labor process. Results: Eleven articles were selected: two systematic reviews (one quantitative and one qualitative), five cohort studies, one case–control study, one cross-sectional observational study, and two qualitative studies. A thorough assessment of the methodology was performed using several specific tools: the Cochrane RoB 2 (Risk of Bias 2) tool for systematic reviews, JBI Critical Appraisal Checklist for Qualitative Research for qualitative studies, STROBE for observational descriptive studies, and CASPe for qualitative studies. The results provided fundamental insights that will contribute to conceptual standardization regarding the effects of water birth on maternal and fetal health. Additionally, a synthesis of the results was performed concerning types of delivery, analgesia use, pain perception, and maternal satisfaction with the water birth experience. Conclusions: In this study, we conclude that the results regarding delivery types, labor durations, and analgesia use found in the literature, along with statistically significant maternal/fetal effects, are crucial for making recommendations regarding the use of water during labor in any of its stages if the woman desires it safely.

Critical appraisal

Hydrotherapy

10.3390/healthcare12030373

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Citations (2)

Eficacia y configuración estructural de la empresa

Alta dirección (1996)

Juan Carlos Sánchez-García

Source

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Citations (1)

Incontinencia urinaria de esfuerzo en mujeres durante el posparto. Revisión bibliográfica

Journal of Negative and No Positive Results: JONNPR (2017)

Jose Manuel Barranco Cuadros Irene Herrera Vargas Raquel Rodríguez-Blanque Juan Carlos Sánchez-García

Introduction: Both pregnancy and childbirth are important risk factors for urinary stress incontinence in women. For its prevention, exercises of the pelvic floor musculature have been shown to be effective. Guidelines for urinary stress incontinence management recommend offering pelvic floor muscle training to women during their first pregnancy as a preventive measure. Objective: To update the information provided in the scientific literature on urinary stress incontinence during postpartum and possible forms of treat it. Methodology: A systematic bibliographic review was carried out in the following databases: PUBMED, COCHRANE, CINHAL, MEDLINE, SciELO and SCOPUS. The date was restricted to the last 5 years (2012- 2017), in Spanish, English and Portuguese. Restrictions were made regarding the type of study, and Randomized Clinical Trials (RCTs) were considered for this review. Results: After reviewing the literature consulted, it is concluded that the training of the pelvic floor musculature is beneficial to prevent the occurrence of urinary stress incontinence during pregnancy and the postpartum period. Conclusions: The results obtained in this review are consistent with previous studies and bibliographic reviews of the same topic. It follows that training of the pelvic floor muscles is beneficial in preventing the occurrence of urinary stress incontinence during pregnancy or postpartum.

Stress incontinence

Pessary

10.19230/jonnpr.1619

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Peer Review #3 of "Physical activity during pregnancy and its influence on delivery time: a randomized clinical trial (v0.1)"

Raquel Rodríguez-Blanque Juan Carlos Sánchez-García Corresp Antonio Manuel Sánchez-López María José Aguilar Cordero

MethodsA randomized trial was performed with 140 healthy pregnant women, divided into an exercise group (EG) (n=70) and a control group (CG) (n=70).The women who composed the study population were recruited at 12 weeks of gestation.The intervention program, termed SWEP (Study of Water Exercise during Pregnancy) began in week 20 of gestation and ended in week 37.Perinatal outcomes were determined by examining the corresponding partographs, recorded by the Maternity Service at the Granada University Hospital Complex. ResultsThe intervention phase of the study took place from June through October 2016, with the 120 women finally included in EG and CG (60 in each group).At term, 63% of the women in EG and 56% of those in CG had a eutocic birth.The average total duration of labor was 389.33±216.18min for the women in EG and 561.30±199.94min for those in CG, a difference of approximately three hours (p<0.001). ConclusionsThe women who exercised in water during their pregnancy presented a shorter duration of labor than those who did not.The difference was especially marked with respect to the duration of the first and second stages of labor.

10.7287/peerj.6370v0.1/reviews/3

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Comparative Analysis of Therapeutic Showers and Bathtubs for Pain Management and Labor Outcomes - A Retrospective Cohort Study

Elena Mellado-García Lourdes Díaz‐Rodríguez Jonathan Cortés‐Martín Juan Carlos Sánchez-García Beatriz Piqueras-Sola

Hydrotherapy, including the use of therapeutic showers and bathtubs, has been studied for its potential benefits in labor pain management. Previous research has indicated that hydrotherapy can alleviate pain, but comparative studies between therapeutic showers and bathtubs are scarce. Objective: This study aims to compare the effects of therapeutic showers and bathtubs on pain perception, labor duration, use of epi-dural analgesia, and maternal and neonatal outcomes during labor. Methods: A total of 124 pregnant women were included in this study. Participants were divided into two groups: those who used a thera-peutic shower and those who used a bathtub during labor. Pain levels were measured using a visual analog scale (VAS). Labor duration, use of epidural analgesia, types of delivery, maternal outcomes (postpartum hemorrhage, perineal status, maternal hypotension, fever, and breastfeeding), and neonatal outcomes (APGAR scores, fetal heart rate, complications, and neonatal unit admissions) were recorded and analyzed. Results: Both the therapeutic shower and the bathtub effectively reduced pain perception, with the bathtub showing a greater reduction in VAS scores. The therapeutic shower group experienced a signifi-cantly shorter labor duration compared to the bathtub group. The majority of participants in both groups did not require epidural analgesia, with no significant differences between the groups. There were no sig-nificant differences in the types of delivery. Maternal outcomes indicated a lower incidence of perineal tears and episiotomies in the therapeutic shower group. Neonatal outcomes, including APGAR scores and fetal heart rate, were similar between the groups, with no significant differences in complications or neo-natal unit admissions. Conclusions: Both therapeutic showers and bathtubs are effective for pain relief during labor, with the bathtub showing a higher reduction in pain intensity. The therapeutic shower is as-sociated with a shorter labor duration and a lower incidence of perineal tears and episiotomies. Both meth-ods are safe for neonatal well-being, making hydrotherapy a viable non-pharmacological option for pain management in labor. However, the therapeutic shower may offer additional benefits in terms of labor du-ration and maternal outcomes.

10.20944/preprints202405.1486.v1

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[Physical activity programmes to reduce overweight and obesity in children and adolescents; a systematic review].

PubMed (2014)

María José Aguilar Cordero A Ortegón Piñero Nelo Vilar Juan Carlos Sánchez-García Juan José García Verazaluce

Obesity treatment has been the subject of much controversy; various authors have recommended the application of a comprehensive treatment programme, and in the light of this previous research, we consider the question of what is the most effective programme of physical activity to reduce overweight and obesity in children and adolescents.To analyse major studies on the effectiveness of physical activity in reducing overweight and obesity in children and adolescents.Systematic review of the results of physical activity programmes, published in scientific articles, to reduce overweight and obesity. Using an automated database search in PubMed and Google Scholar, conducted from October 2013 to March 2014, we identified 85 valid items. In selecting the items, the criteria applied included the usefulness and relevance of the subject matter and the credibility or experience of the research study authors. The internal and external validity of each of the articles reviewed was taken into account.This review confirmed the effectiveness of physical activity in reducing overweight and obesity in children and adolescents. The most effective programmes were those combining aerobic and anaerobic exercises. It is generally accepted that at least 180 minutes per week should be dedicated to exercise, in the form of three 60-minute sessions of moderate intensity. Such programmes could be sufficient for persons with overweight or obesity. Researchers in this field agree that when a diet based on an appropriate distribution of meals is combined with regular physical activity, they reinforce each other, and thus optimum results are obtained. Weight reduction programmes that take account of family involvement are more effective than nutrition education itself or other routine interventions that fail to consider family involvement. The role of pa rents and of the persons around the child or adolescent is essential to reinforce positive behaviour toward lifestyle change.Introducción: El tratamiento contra la obesidad ha sido muy discutido y varios autores abogan por un tratamiento integral de la obesidad. Todos los referentes conducen a plantear ¿cuál es el programa de actividad física más efectivo para reducir el sobrepeso y la obesidad de niños y adolescentes? Objetivo: Analizar los principales estudios sobre la eficacia de la actividad física para reducir el sobrepeso y la obesidad de niños y adolescentes. Método: Revisión sistemática de los resultados de programas de actividad física para reducir el sobrepeso y la obesidad publicados en artículos científicos. Se identificaron 85 artículos a través de la búsqueda automatizada en las bases de datos PUBMED y Google Scholar; se llevó a cabo entre los meses de octubre de 2013 y marzo de 2014. Para seleccionar los artículos fue preciso considerar la utilidad y la relevancia del tema estudiado y la credibilidad o experiencia de los autores en la temática. Se tuvo en cuenta la validez interna y externa de cada uno de los artículos revisados. Conclusiones: Se identificó la efectividad de la actividad física para reducir el sobrepeso y la obesidad de niños y adolescentes. El programa de actividad física más efectivo es el que combina ejercicios aeróbicos y anaeróbicos. Existe consenso en acumular más de 180 minutos a la semana dedicados a estos fines, con 3 sesiones de 60 minutos cada una de ejercicio físico a la semana. De una intensidad moderada, podrían ser suficientes para ejecutar un programa de ejercicio físico para esas personas con sobrepeso y obesidad. Coinciden los autores en que, cuando se combina una dieta controlada por una adecuada distribución de las comidas y con la práctica de actividad física, se potencian mutuamente, con lo que se obtie nen los mejores resultados. Los programas de reducción de peso que tengan en cuenta la participación familiar son más eficaces que la propia educación alimentaria y otras intervenciones de rutina que no consideren esa participación familiar. El rol de los padres y de las personas que rodean al niño y al adolescente es fundamental para reforzar las conductas positivas hacia el cambio de estilo de vida.

10.3305/nh.2014.30.4.7680

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Ehlers–Danlos Syndrome Type Arthrochalasia: A Systematic Review

International Journal of Environmental Research and Public Health (2022)

Marta Martín-Martín Jonathan Cortés‐Martín María Isabel Tovar-Gálvez Juan Carlos Sánchez-García Lourdes Díaz‐Rodríguez

Ehlers-Danlos syndrome type arthrochalasia (aEDS) is a rare genetic disease characterized by severe generalized joint hypermobility, bilateral congenital hip dislocation, skin hyperextensibility, muscle hypotonia, and mild dysmorphic features. It is an autosomal dominant connective tissue disease causing defects in collagen, associated with two genes, COL1A1 or COL1A2. Only about 42 cases have been published worldwide. Treatment is currently symptomatic and focuses on increasing the quality of life of these patients, as there is no curative treatment. The main objective of the review was to update information on Ehlers-Danlos syndrome type arthrochalasia from scientific publications. The review report was carried out in accordance with the criteria of the Preferred Reporting Items for Systematic reviews and MetaAnalyses (PRISMA) review protocol, by searching Orphanet, OMIM, PubMed, and Scopus, as well as free sources. A total of 20 articles were analyzed, which, after analysis, provide an updated report that aims to establish a solid starting point for future lines of research.

Joint hypermobility

Ehlers–Danlos syndrome

Rare disease

10.3390/ijerph19031870

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Physical Therapies in the Treatment of Post-COVID Syndrome: A Systematic Review

Biomedicines (2023)

Juan Carlos Sánchez-García María Rentero Moreno Beatriz Piqueras-Sola Jonathan Cortés‐Martín Antonio Liñán-González

Introduction: Several days to months after diagnosis of SARS-CoV-2, 35% of patients have persistent symptoms in high incidence. This is referred to as post-COVID-19 Syndrome. There is a pressing need to find a way to help patients with the manifested symptoms. Objective: To show the different therapies that exist for post-COVID Syndrome and their efficacy. Methodology: A systematic review of the scientific literature was carried out. The data search was carried out in Scopus, PubMed, Cinahl, and Web of Science. Of the 106 articles found, 12 articles were obtained after applying the following eligibility criteria. Results: Interventions related to respiratory musculature and moderate intensity exercise both in supervised face-to-face sessions and in supervised home sessions led patients to a significant improvement in the symptoms presented. Conclusion: Physical therapies significantly reduce fatigue and dyspnea as well as other symptoms related to quality of life.

CINAHL

Web of science

10.3390/biomedicines11082253

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