Terapia Manual Bolivia

18/04/2026

18/04/2026

https://www.facebook.com/share/18UdQkahGS/?mibextid=wwXIfr

𝗨𝗻𝗹𝗼𝗰𝗸𝗶𝗻𝗴 𝘁𝗵𝗲 𝗠𝘆𝘀𝘁𝗲𝗿𝘆 𝗼𝗳 𝗠𝗮𝗻𝘂𝗮𝗹 𝗧𝗵𝗲𝗿𝗮𝗽𝘆: 𝗪𝗵𝗮𝘁 𝗗𝗼 𝗣𝗮𝘁𝗶𝗲𝗻𝘁𝘀 𝗔𝗰𝘁𝘂𝗮𝗹𝗹𝘆 𝗕𝗲𝗹𝗶𝗲𝘃𝗲?

⬛ Manual therapy has long been defined as the skillful application of mechanical force by a trained professional to modulate pain and improve the quantity and quality of movement.
⬛ It is a highly recommended and widespread intervention in physical rehabilitation, yet the specific cellular, physiological, and molecular mechanisms behind how it works are still being uncovered by contemporary research.
⬛ While researchers study these complex biomechanical and neurophysiological mechanisms, a fascinating question remains: what do the patients themselves think is happening to their bodies?
⬛ A recent exploratory qualitative study sought to answer exactly this question by exploring patients' understanding of how manual therapy works.
⬛ The researchers conducted virtual, one-on-one interviews with 26 adults seeking physical therapy for musculoskeletal conditions.

𝗧𝗵𝗲 𝗕𝗶𝗴 𝗙𝗶𝗻𝗱𝗶𝗻𝗴: 𝗢𝘂𝘁𝗰𝗼𝗺𝗲𝘀 𝘃𝘀. 𝗠𝗲𝗰𝗵𝗮𝗻𝗶𝘀𝗺𝘀 🔍

⬛ One of the most revealing takeaways from the study is that participants were more than twice as likely to describe the outcomes of manual therapy, the results it produces, such as decreased pain, rather than the mechanisms, how it actually works inside the body.
⬛ When asked to explain how the therapy functions, patient responses generally fell into three distinct themes: mechanical, neurophysiological, and psychological effects.

𝟭. 𝗠𝗲𝗰𝗵𝗮𝗻𝗶𝗰𝗮𝗹 𝗘𝗳𝗳𝗲𝗰𝘁𝘀: 𝗧𝗵𝗲 “𝗙𝗶𝘅-𝗜𝘁” 𝗙𝗮𝗹𝗹𝗮𝗰𝘆

⬛ Mechanical beliefs overwhelmingly dominated the patients' understanding of manual therapy.
⬛ Patients expressed that manual therapy physically altered or realigned their body structures.
⬛ The most common subthemes within this category included:
⬛ Increased mobility: Patients believed the therapy physically elongates muscles, adds space in the joints, or breaks up scar tissue that gets in the way of bone structures.
⬛ Improved circulation: Many felt that the mechanical forces of massage or movement brought helpful blood flow into the area and removed toxins or dead cells.
⬛ Realignment of the body: Patients commonly believed the provider was repositioning bones, returning discs to a neutral position, or putting structures back into their proper place.
⬛ Crucially, these mechanical beliefs demonstrate a discrepancy between patient understanding and contemporary evidence.
⬛ While many patients view manual therapy as a tool to change the body's architecture, modern science largely refutes the outdated philosophy that manual interventions create long-term structural changes or literally put joints back in place.

𝟮. 𝗡𝗲𝘂𝗿𝗼𝗽𝗵𝘆𝘀𝗶𝗼𝗹𝗼𝗴𝗶𝗰𝗮𝗹 𝗘𝗳𝗳𝗲𝗰𝘁𝘀: 𝗣𝗮𝗶𝗻, 𝗡𝗲𝗿𝘃𝗲𝘀, 𝗮𝗻𝗱 𝗠𝗼𝘃𝗲𝗺𝗲𝗻𝘁

⬛ Beyond structural adjustments, half of the participants recognized that manual therapy created changes within their peripheral or central nervous system, mainly related to pain perception and sensation.
⬛ Decreased pain: Patients accurately noted the therapy's analgesic pain-relieving effects, with some specifically citing the release of endorphins or the blocking of pain signals.
⬛ This concept mirrors the gate control theory of pain, where a different tactile stimulus like massage or dry needling interrupts the pain cycle.
⬛ Enhanced motor performance and nerve stimulation: Patients felt manual therapy re-educated their muscles, restored sensation, and improved signaling in neural tissue, allowing them to exercise with greater ease.

𝟯. 𝗣𝘀𝘆𝗰𝗵𝗼𝗹𝗼𝗴𝗶𝗰𝗮𝗹 𝗘𝗳𝗳𝗲𝗰𝘁𝘀: 𝗧𝗵𝗲 𝗣𝗼𝘄𝗲𝗿 𝗼𝗳 𝗧𝗼𝘂𝗰𝗵

⬛ The third theme highlighted how manual therapy creates favorable shifts in a patient's overall mental state and their perceived value of the care they receive.
⬛ Promotion of positive thoughts: Patients indicated that manual therapy gave them the confidence to move and push themselves during recovery.
⬛ This increased confidence embodies an increase in self-efficacy and a decrease in the fear of movement kinesiophobia, which are known psychological benefits of the intervention.
⬛ Increased value of care: The hands-on nature of the treatment was highly valued by participants.
⬛ Patients felt that physical touch provided a sense of safety, relaxation, and an intimate connection with their therapist that passive exercises alone could not achieve.

𝗧𝗵𝗲 𝗖𝗹𝗶𝗻𝗶𝗰𝗮𝗹 𝗜𝗺𝗽𝗹𝗶𝗰𝗮𝘁𝗶𝗼𝗻: 𝗧𝗶𝗺𝗲 𝗳𝗼𝗿 𝗕𝗲𝘁𝘁𝗲𝗿 𝗖𝗼𝗻𝘃𝗲𝗿𝘀𝗮𝘁𝗶𝗼𝗻𝘀

⬛ Ultimately, the study found that patients predominantly view manual therapy as a mechanical fix for a structural problem, largely unaware of the true mechanisms driving their recovery.
⬛ Because patients' understanding often aligns with outdated biomedical models rather than current evidence, providers need to be highly aware of these preconceived beliefs.
⬛ Manual therapy is increasingly being reconceptualized as a collaborative process rather than a passive treatment.
⬛ By understanding a patient's prior experiences and actively inviting them into a shared decision-making process, physical therapists and other providers can better educate their patients on not just the benefits of manual therapy, but the true, evidence-based science of how it facilitates recovery.

16/10/2025

¡Un saludo a mis nuevos seguidores! ¡Estoy feliz de que me sigan!

Lesli Ledezma, Yoselin Basualdo, Gustavo Vega Davila, Luis Crespo

11/10/2025

Estudio de caso!! Sociedad científica de terapia manual y movimiento !!

08/09/2025

Día de la fisioterapia!!!😎

06/12/2024

https://www.facebook.com/share/p/1EvR1q5Pbo/?mibextid=WC7FNe

Just published in JAMA 🔥

Axial Spondyloarthritis : A Review

📘 https://jamanetwork.com/journals/jama/article-abstract/2827540

👉 Axial spondyloarthritis is a multisystem inflammatory disease characterized by inflammation of the axial skeleton, including the sacroiliac joints and the spine. Axial spondyloarthritis can also affect the peripheral joints and organs such as the skin, eyes, and gastrointestinal tract (peripheral arthritis, enthesitis, or uveitis in about 20% of cases, https://pubmed.ncbi.nlm.nih.gov/19147614/). Axial spondyloarthritis encompasses radiographic (known as ankylosing spondylitis) as well as nonradiographic disease (https://pubmed.ncbi.nlm.nih.gov/19297345/).

👉 It affects approximately 1% of adults in the US and is associated with impaired physical function and reduced quality of life (https://pubmed.ncbi.nlm.nih.gov/23841117/).

👉 Inflammatory chronic back pain characterized by gradual onset starting before age 45 years, prolonged morning stiffness, improvement with exercise, and lack of improvement with rest is the most common symptom of axial spondyloarthritis and affects more than 80% of patients.

👉 The pathogenesis of axial spondyloarthritis may involve genetic predisposition (https://pubmed.ncbi.nlm.nih.gov/25861975/), gut microbial dysbiosis (https://pubmed.ncbi.nlm.nih.gov/26002022/), and entheseal trauma (https://pubmed.ncbi.nlm.nih.gov/30266977/), with immune cell infiltration of the sacroiliac joints and entheseal insertion areas in the spine.

👉 There are currently no diagnostic criteria for axial spondyloarthritis. The diagnosis, often delayed 6 to 8 years after symptom onset (https://pubmed.ncbi.nlm.nih.gov/33428758/), is based on history (ie, inflammatory back pain, sensitivity, 74%-81%; specificity, 25%-44%), https://pubmed.ncbi.nlm.nih.gov/30713715/), laboratory findings (human leukocyte antigen B27–positive, sensitivity, 50%; specificity, 90%, https://pubmed.ncbi.nlm.nih.gov/38125058/) and elevated C-reactive protein level (sensitivity, 35%; specificity, 91%, https://acrabstracts.org/abstract/systematic-literature-review-and-meta-analysis-informing-the-development-of-2023-spondyloarthritis-research-and-treatment-network-spartan-referral-recommendations-for-axial-spondyloarthritis/), and imaging findings consisting of sacroiliitis on plain radiography (sensitivity, 66%; specificity, 68%, https://pubmed.ncbi.nlm.nih.gov/34049855/) or magnetic resonance imaging (sensitivity, 78%; specificity, 88%, https://pubmed.ncbi.nlm.nih.gov/31797168/).

👉 First-line treatments are exercise therapy and nonsteroidal anti-inflammatory drugs (NSAIDs). Exercise therapy is important for muscle strengthening, to maintain good range of motion and appropriate posture. A multicenter randomized clinical trial of 100 patients with axial spondyloarthritis reported that supervised high-intensity exercise led to improvements in disease activity scores (https://pubmed.ncbi.nlm.nih.gov/30745314/).

👉 As less than 25% of patients achieve complete symptom control with NSAIDs, approximately 75% of patients require biologic drugs (tumor necrosis factor inhibitors [anti-TNF agents], interleukin 17 inhibitors [anti–IL-17 agents]) or targeted synthetic disease-modifying antirheumatic agents (Janus kinase [JAK] inhibitors) to reduce symptoms, prevent structural damage, and improve quality of life.

📷 Figure (https://jamanetwork.com/journals/jama/article-abstract/2827540): Multiple mechanisms play a role, including HLA-B27, gut microbiome, and mechanical stress. The interaction between dendritic cells and CD8+ T cells, as well as the activation of CD4+ T cells, promote an inflammatory cascade characterized by the production of several cytokines including interleukin (IL) 23, IL-22, IL-17, and tumor necrosis factor. With chronic inflammation, new bone formation will occur. This is thought to be due to mesenchymal cell proliferation leading to osteoblast differentiation, mediated by multiple signaling pathways including Wnt, bone morphogenetic protein, and hedgehog.

12/04/2024

¡Descubre la Excelencia en Terapia Manual Neuromusculoesquelética!

Únete a nuestro emocionante curso liderado por destacados expertos internacionales en el campo de la fisioterapia:

🌟 Germán Digerolamo desde Argentina, con su vasta experiencia como docente en terapia manual y enfoques basado en neurociencias.

🌟 Desde Italia, Filippo Michelli, un pionero en técnicas avanzadas de neuromodulación y rehabilitación.

🌟 Juan Marcos Moreno desde España, reconocido por su maestría en la aplicación de técnicas de terapia manual en el tratamiento de lesiones musculoesqueléticas.

🌟 Y desde Bolivia, Dery Mérida, quien aporta su experiencia en la integración de la terapia manual con enfoques en el modelo Biopsicosocial, para el bienestar del paciente.

Descubre nuevas perspectivas, técnicas avanzadas y enfoques innovadores en la terapia manual neuromusculoesquelética. ¡No te pierdas esta oportunidad única de aprender de los mejores!

🗓️ Fecha: 3 al 5 de mayo
🕒 Horario: de 8:30 a 12:30 y de 14:00 a 18:00
📍 Lugar: Cochabamba / Bolivia

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