University of Lleida

Application of an action protocol focused on the application of non-pharmacological interventions for managing delirium in the process of prevention, diagnosis and treatment, evaluated using an e-health intervention, with a tablet to introduce on it the data about the prevention, diagnostic and treatment process of each recluted patient, in the Igualada Hospital Center, once a day.

This clinical trial aims to collect evidence on the clinical benefits and the socioeconomic impact of integrating a novel wearable powered lower-limb exoskeleton for gait rehabilitation in acute/subacute spinal cord injured individuals and to evaluate the efficiency of this technology to the current standard of care in the Spanish Healthcare System (SNS).. The main questions it aims to answer are:
* Is robotic therapy for gait rehabilitation more effective and efficient than conventional therapy?
* Does robotic therapy for gait rehabilitation reduce the burden on healthcare professionals and caregivers?
* Does robotic therapy for gait rehabilitation reduce direct healthcare costs?
* Does robotic therapy for gait rehabilitation reduce intervention-related costs?
Researchers will compare a novel wearable powered lower-limb exoskeleton for gait rehabilitation to conventional therapy to see if the robotic exoskeleton is more effective and efficient in improving clinical benefits and to assess if it reduces the burden of healthcare professionals and caregivers, as well as healthcare and intervention-related costs.
Participants will:
* Be randomized on a 1:1 basis to receive rehabilitation treatment with either the robotic exoskeleton or conventional therapy for gait recovery, 3 times a week on non-consecutive days for 8 weeks (24-session program).
* Undergo a pre- and post-intervention assessment of clinical, functional, physiological, psychological, and socioeconomic variables.
* Have a follow-up visit 2 months after the end of the treatment.

Background: Pain is a multifactorial experience where psychological and emotional factors influence the transition from acute to chronic pain, prognosis, and the adoption of inappropriate self-management strategies. In addition to psychological and emotional factors, healthcare professionals can contribute to the development of chronic disabilities in their patients by promoting hypervigilance and restricting normal activities, potentially reinforcing or altering patients' perceptions, leading to limited mobility. Existing scientific literature suggests that patients with chronic pain often feel they do not receive sufficient information from healthcare professionals that could help them better understand and manage pain, thereby improving their quality of life.
Objectives:
1. To assess the current knowledge of pain neurophysiology among primary care professionals (medicine, physiotherapy, nursing, nutrition, and psychology) in Spain.
2. To evaluate attitudes and beliefs about chronic low back pain among primary care professionals (medicine, physiotherapy, nursing, nutrition, and psychology) in Spain.
3. To examine fear-avoidance beliefs related to pain among primary care professionals (medicine, physiotherapy, nursing, nutrition, and psychology) in Spain.
Methodology: A cross-sectional descriptive study will be conducted to collect information from primary care health professionals (medicine, physiotherapy, psychology, nutrition, and nursing) in Spain, focusing on their current knowledge, attitudes, and beliefs about musculoskeletal pain.
Applicability: This study will provide valuable insights into the current state of knowledge, attitudes, and beliefs about musculoskeletal pain among primary care health professionals in Spain. The findings will guide future educational interventions and policy recommendations to improve the management of musculoskeletal pain in primary care settings in Spain.
Relevance: Scientifically, this will be the first study to evaluate the knowledge of primary care health professionals in Spain regarding pain neurophysiology, attitudes and beliefs about chronic low back pain, and fear-avoidance attitudes.