{"id":116698,"date":"2018-03-11T10:45:57","date_gmt":"2018-03-11T10:45:57","guid":{"rendered":"https:\/\/www.deberes.net\/tesis\/sin-categoria\/electrolisis-percutanea-intratisular-y-calidad-de-la-atencion-en-la-epicondilalgia-cronica\/"},"modified":"2018-03-11T10:45:57","modified_gmt":"2018-03-11T10:45:57","slug":"electrolisis-percutanea-intratisular-y-calidad-de-la-atencion-en-la-epicondilalgia-cronica","status":"publish","type":"post","link":"https:\/\/www.deberes.net\/tesis\/fisioterapia\/electrolisis-percutanea-intratisular-y-calidad-de-la-atencion-en-la-epicondilalgia-cronica\/","title":{"rendered":"Electr\u00f3lisis percut\u00e1nea intratisular y calidad de la atenci\u00f3n en la epicondilalgia cr\u00f3nica."},"content":{"rendered":"<h2>Tesis doctoral de <strong> Francisco Javier Minaya Mu\u00f1oz <\/strong><\/h2>\n<p>Resumen   objetivos  desarrollar y evaluar indicadores fiables, v\u00e1lidos y \u00fatiles para medir la calidad a pacientes con epicondilalgia lateral. Evaluar la efectividad cl\u00ednica y ecogr\u00e1fica a corto, medio y largo plazo de la t\u00e9cnica electr\u00f3lisis percut\u00e1nea intratisular (epi\u00c2\u00bf) combinado con un programa de ejercicios exc\u00e9ntricos y estiramientos sobre la epicondilalgia lateral y determinar su coste-efectividad.  material y m\u00e9todos  estudio de construcci\u00f3n y pilotaje de indicadores para pacientes con epicondilalgia lateral, y estudio cl\u00ednico experimental con un grupo y medidas repetidas (inicio, alta y a 6, 26 y 52 semanas de seguimiento).    para medir la calidad de la atenci\u00f3n prestada a los pacientes con epicondilalgia lateral se llev\u00f3 a cabo el desarrollo de diferentes indicadores de calidad por un grupo multidisciplinar de expertos en gesti\u00f3n de la calidad de los servicios de la salud. El proceso se bas\u00f3 en tres pasos bien estructurados.  en el estudio cl\u00ednico a los pacientes se les aplic\u00f3 una sesi\u00f3n de epi\u00c2\u00bf a la semana durante 4-6 semanas, asociado a un programa de ejercicios exc\u00e9ntricos y estiramientos. Las principales variables de resultado que se midieron fueron la severidad del dolor (mediante eva, algometr\u00eda de presi\u00f3n, test ortop\u00e9dicos), la discapacidad (cuestionario dash), los cambios estructurales en el tend\u00f3n y la hipervascularizaci\u00f3n (ecograf\u00eda), y la percepci\u00f3n del paciente de los resultados obtenidos (escala de 4 puntos). Por otro lado, se valor\u00f3 la relaci\u00f3n de coste-efectividad de la intervenci\u00f3n terap\u00e9utica. El coste por proceso se analiz\u00f3 compar\u00e1ndolo con los casos quir\u00fargicos y el gasto asociado y se bas\u00f3 sobre criterios de reducci\u00f3n de la intensidad del dolor.  resultados  se desarrollaron 12 indicadores fiables (kappa&gt;0.8) para medir la valoraci\u00f3n y tratamiento. Hubo mejoras cl\u00ednicas y ecogr\u00e1ficas significativas al alta y ausencia de recidivas durante el seguimiento. Se estima que el coste por paciente del tratamiento con epi\u00c2\u00bf es 16 veces inferior que con cirug\u00eda.  conclusiones  &quot;\tlos indicadores de calidad construidos son fiables, basados en la evidencia y aplicables a los pacientes con epicondilalgia lateral.  &quot;\tel tratamiento con epi\u00c2\u00bf asociado con un programa de ejercicios exc\u00e9ntricos y estiramientos ejora los s\u00edntomas y regenera el tejido, con una relaci\u00f3n coste-efectividad muy aceptable.   abstract  aims  to develop and evaluate reliable, valid and useful clinical quality measures (qms) which may be used in the process of care of patients with lateral epicondylalgia. To assess the clinical and ultrasonographic effectiveness of intratissue percutaneous electrolysis (the epi\u00c2\u00bf technique) combined with a program of eccentric exercise (eccex) and stretching in the short, medium and long term for patients with lateral epicondylalgia and to determine its cost-effectiveness.  material and methods  study of construction and piloting testing of indicators for patients with lateral epicondylalgia was carried out, and experimental clinical design with a group and repeated measures (baseline, discharge and 6, 26 and 52 weeks follow-up).   to measure the quality of care provided to patients with lateral epicondylalgia the development of different quality indicators was carried out by a multidisciplinary group of experts in quality management of health services. The process was based on three well-structured steps.  in the clinical design, the patients received one session of us-guided epi\u00c2\u00bf technique per week over 4-6 weeks, associated with a home program of eccex and stretching. The main outcome variables measured were pain severity (using eva, pressure algometry, orthopedic test), disability (dash questionnaire), structural changes in the tendon and hypervascularity (ultrasound), and patient&apos;s perceptions of overall outcome (4 point scale). On the other hand, the ratio of cost-effectiveness of therapeutic intervention was assessed. The cost per case was analyzed by comparing it with surgical cases and the associated expense and was based on criteria for decreasing pain intensity.  results  a set of 12 reliable indicators (kappa &gt; 0.8) was developed to measure the assessment and treatment. There were significant clinical and ultrasonographic improvements at discharge and no recurrences during follow-up period. It is estimated that the cost per patient of treatment with epi\u00c2\u00bf technique is 16 times lower than with surgery.  conclusions  &quot;\tthe built quality indicators are reliable, evidence-based and applicable to patients with lateral epicondylalgia. &quot;\ttreatment with the epi\u00c2\u00bf technique combined with a program of eccentric exercise (eccex) and stretching improves symptoms and regenerates tissue, with a very acceptable cost-effectiveness ratio.<\/p>\n<p>&nbsp;<\/p>\n<h3>Datos acad\u00e9micos de la tesis doctoral \u00ab<strong>Electr\u00f3lisis percut\u00e1nea intratisular y calidad de la atenci\u00f3n en la epicondilalgia cr\u00f3nica.<\/strong>\u00ab<\/h3>\n<ul>\n<li><strong>T\u00edtulo de la tesis:<\/strong>\u00a0 Electr\u00f3lisis percut\u00e1nea intratisular y calidad de la atenci\u00f3n en la epicondilalgia cr\u00f3nica. <\/li>\n<li><strong>Autor:<\/strong>\u00a0 Francisco Javier Minaya Mu\u00f1oz <\/li>\n<li><strong>Universidad:<\/strong>\u00a0 Murcia<\/li>\n<li><strong>Fecha de lectura de la tesis:<\/strong>\u00a0 24\/11\/2014<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<h3>Direcci\u00f3n y tribunal<\/h3>\n<ul>\n<li><strong>Director de la tesis<\/strong>\n<ul>\n<li>Francesc Medina  I Mirapeix<\/li>\n<\/ul>\n<\/li>\n<li><strong>Tribunal<\/strong>\n<ul>\n<li>Presidente del tribunal: Francisco javier Jimeno serrano <\/li>\n<li>pablo Herrero gallego (vocal)<\/li>\n<li>Jos\u00e9 Antonio Martin urrialde (vocal)<\/li>\n<li>jacinto Javier Mart\u00ednez pay\u00e1 (vocal)<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Tesis doctoral de Francisco Javier Minaya Mu\u00f1oz Resumen objetivos desarrollar y evaluar indicadores fiables, v\u00e1lidos y \u00fatiles para medir la 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