{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T01:57:58Z","timestamp":1760147878245,"version":"build-2065373602"},"reference-count":25,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2023,3,7]],"date-time":"2023-03-07T00:00:00Z","timestamp":1678147200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Fundaci\u00f3n de Investigation Biomedica del Hospital Puerta de Hierro de Majadahonda"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background: Pressure ulcers are a public health problem given the impact that they have on morbidity, mortality and the quality of life and participation of patients who suffer from them. Therefore, the main objective of this study was to evaluate the presence of differences in the radiofrequency parameters applied to complex pressure ulcers throughout the sessions and between the right and left leg. As a secondary objective, the subjective perceptions of the effects of the treatment by both the patients and the practitioner were analyzed. Methods: We performed a secondary analysis of data from a prospective study involving 36 patients from the Hospital de Guadarrama in Madrid, Spain, who presented ulcers in the lower limbs. Ten treatment sessions of radiofrequency were administered with a frequency of one session\/week, collecting the data referring to the variables in each of the sessions. The main outcome variables were the radiofrequency parameters automatically adjusted in each session and that referred to the frequency (Hz), maximum and average power (W), absorbed energy by the ulcer (J\/cm2) and temperature (\u00b0C) reached by the tissues. On the other hand, the subjective perception of the results was evaluated using the Global Response Assessment (GRA), a Likert-type scale that scores the treatment results from 1 (significantly worse) to 5 (significantly better). Likewise, the satisfaction of both the patients and the professional were evaluated using a 10-point numerical scale. Results: The ANOVA test showed significant differences (p &lt; 0.05) throughout the sessions except in patient satisfaction. The ANOVA test showed significant differences (p &lt; 0.05) between both legs and over time in all parameters except for frequency. The presence of significant differences (p &lt; 0.05) was observed over time between legs compared to the initial values in the absorbed energy and in temperature, with higher final values in the absorbed energy in the left leg compared to the right (26.31 \u00b1 3.75 W vs. 17.36 \u00b1 5.66 W) and a moderate effect on both (R2 = 0.471 and 0.492, respectively). The near absence of changes in the satisfaction of both the patients and the professional was observed, while the score in the GRA decreased continuously throughout the sessions. Conclusions: Radiofrequency parameters are indicative of an improved clinical response to ulcers. In addition, higher radiofrequency exposure increases healing capacity. However, the subjective perception of treatment outcomes worsened, which may be related to the chronic nature of the ulcers, leading to patients\u2019 expectations not being met.<\/jats:p>","DOI":"10.3390\/medicina59030516","type":"journal-article","created":{"date-parts":[[2023,3,7]],"date-time":"2023-03-07T02:07:38Z","timestamp":1678154858000},"page":"516","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Presence of Differences in the Radiofrequency Parameters Applied to Complex Pressure Ulcers: A Secondary Analysis"],"prefix":"10.3390","volume":"59","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7417-4060","authenticated-orcid":false,"given":"Miguel \u00c1ngel","family":"Barbas-Monjo","sequence":"first","affiliation":[{"name":"Functional Recovery Unit, Guadarrama Hospital, 28440 Madrid, Spain"},{"name":"Research Group in Nursing and Health Care, Puerta de Hierro Health Research Institute\u2014Segovia de Arana (IDIPHISA), 28222 Majadahonda, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0254-6501","authenticated-orcid":false,"given":"Eleuterio A.","family":"S\u00e1nchez-Romero","sequence":"additional","affiliation":[{"name":"Department of Physiotherapy, Faculty of Sport Sciences, Universidad Europea de Madrid, 28670 Villaviciosa de Od\u00f3n, Spain"},{"name":"Physiotherapy and Orofacial Pain Working Group, Sociedad Espa\u00f1ola de Disfunci\u00f3n Craneomandibular y Dolor Orofacial (SEDCYDO), 28009 Madrid, Spain"},{"name":"Musculoskeletal Pain and Motor Control Research Group, Faculty of Sport Sciences, Universidad Europea de Madrid, 28670 Villaviciosa de Od\u00f3n, Spain"},{"name":"Department of Physiotherapy, Faculty of Health Sciences, Universidad Europea de Canarias, 38300 Santa Cruz de Tenerife, Spain"},{"name":"Musculoskeletal Pain and Motor Control Research Group, Faculty of Health Sciences, Universidad Europea de Canarias, 38300 Santa Cruz de Tenerife, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3239-7626","authenticated-orcid":false,"given":"Jorge Hugo","family":"Villafa\u00f1e","sequence":"additional","affiliation":[{"name":"IRCCS Fondazione Don Carlo Gnocchi, 20148 Milan, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7140-1520","authenticated-orcid":false,"given":"Lidia","family":"Mart\u00ednez-Rolando","sequence":"additional","affiliation":[{"name":"Rey Juan Carlos University Hospital of M\u00f3stoles, 28933 Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jara","family":"Velasco Garc\u00eda Cuevas","sequence":"additional","affiliation":[{"name":"Functional Recovery Unit, Guadarrama Hospital, 28440 Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Juan Nicol\u00e1s","family":"Cuenca-Zaldivar","sequence":"additional","affiliation":[{"name":"Departamento de Enfermer\u00eda y Fisioterapia, Grupo de Investigaci\u00f3n en Fisioterapia y Dolor, Universidad de Alcal\u00e1, Facultad de Medicina y Ciencias de la Salud, 28801 Alcal\u00e1 de Henares, Spain"},{"name":"Research Group in Nursing and Health Care, Puerta de Hierro Health Research Institute\u2014Segovia de Arana (IDIPHISA), 28222 Majadahonda, Spain"},{"name":"Primary Health Center \u201cEl Abaj\u00f3n\u201d, Las Rozas de Madrid, 28231 Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2023,3,7]]},"reference":[{"key":"ref_1","first-page":"e1","article-title":"Implantaci\u00f3n del programa \u201cCentros Comprometidos con la Excelencia en Cuidados\u201d en el Hospital Universitario Virgen de las Nieves","volume":"95","year":"2021","journal-title":"Rev. Espa\u00f1ola De Salud P\u00fablica"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"634","DOI":"10.1111\/iwj.13071","article-title":"The national cost of hospital-acquired pressure injuries in the United States","volume":"16","author":"Padula","year":"2019","journal-title":"Int. Wound J."},{"key":"ref_3","first-page":"CD012196","article-title":"Electrical stimulation for treating pressure ulcers","volume":"1","author":"Arora","year":"2020","journal-title":"Cochrane Database Syst. Rev."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"153","DOI":"10.1111\/nyas.13569","article-title":"Update on management of diabetic foot ulcers: Diabetic foot ulcers","volume":"1411","author":"Everett","year":"2018","journal-title":"Ann. N. Y. Acad. Sci."},{"key":"ref_5","first-page":"1799","article-title":"Effects of care bundles for patients with pressure ulcers and the impact on self-care efficacy","volume":"13","author":"Mao","year":"2021","journal-title":"Am. J. Transl. Res."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"881","DOI":"10.1016\/j.jaad.2018.12.069","article-title":"Pressure ulcers: Pathophysiology, epidemiology, risk factors, and presentation","volume":"81","author":"Mervis","year":"2019","journal-title":"J. Am. Acad. Dermatol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1317","DOI":"10.1016\/S0140-6736(21)01258-7","article-title":"Tracking development assistance for health and for COVID-19: A review of development assistance, government, out-of-pocket, and other private spending on health for 204 countries and territories, 1990\u20132050","volume":"398","author":"Micah","year":"2021","journal-title":"Lancet"},{"key":"ref_8","first-page":"8","article-title":"Chronic Wounds: Evaluation and Management","volume":"101","author":"Bowers","year":"2020","journal-title":"Am. Fam. Physician"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"e000409","DOI":"10.1136\/bmjoq-2018-000409","article-title":"Reducing pressure ulcers across multiple care settings using a collaborative approach","volume":"8","author":"Wood","year":"2019","journal-title":"BMJ Open Qual."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"253","DOI":"10.1097\/01.ASW.0000415342.37554.ed","article-title":"Retrospective analysis of pulsed radiofrequency energy therapy use in the treatment of chronic pressure ulcers","volume":"25","author":"Isenberg","year":"2012","journal-title":"Adv. Ski. Wound Care"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"908","DOI":"10.1097\/DSS.0000000000001925","article-title":"Radiofrequency Therapy and Noncosmetic Cutaneous Conditions","volume":"45","author":"Ekelem","year":"2019","journal-title":"Dermatol. Surg."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"132","DOI":"10.1111\/j.1742-481X.2010.00759.x","article-title":"A case history of multimodal therapy in healing a complicated diabetic foot wound: Negative pressure, dermal replacement and pulsed radio frequency energy therapies","volume":"8","author":"Frykberg","year":"2011","journal-title":"Int. Wound J."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"523","DOI":"10.1097\/01.WON.0000335966.98607.1c","article-title":"Pulsed radio frequency energy in the treatment of complex diabetic foot wounds: Two cases","volume":"35","author":"Larsen","year":"2008","journal-title":"J. Wound Ostomy Cont. Nurs."},{"key":"ref_14","first-page":"225","article-title":"\u201cDifficult-to treat\u201d ulcers management: Use of pulse dose radiofrequency","volume":"84","author":"Quarto","year":"2013","journal-title":"Ann. Ital. Di Chir."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"147","DOI":"10.1089\/acm.2019.0165","article-title":"Does the Application of Tecar Therapy Affect Temperature and Perfusion of Skin and Muscle Microcirculation? A Pilot Feasibility Study on Healthy Subjects","volume":"26","author":"Clijsen","year":"2020","journal-title":"J. Altern. Complement. Med."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"63","DOI":"10.4321\/S1134-928X2021000100013","article-title":"Radiofrecuencia en la cicatrizaci\u00f3n de heridas cr\u00f3nicas. Una revisi\u00f3n en hospital de media estancia","volume":"32","year":"2021","journal-title":"Gerokomos"},{"key":"ref_17","doi-asserted-by":"crossref","unstructured":"Fern\u00e1ndez-Carnero, J., Beltr\u00e1n-Alacreu, H., Arribas-Romano, A., Cerezo-T\u00e9llez, E., Cuenca-Zaldivar, J.N., S\u00e1nchez-Romero, E.A., Lerma Lara, S., and Villafa\u00f1e, J.H. (2023). Prediction of Patient Satisfaction after Treatment of Chronic Neck Pain with Mulligan\u2019s Mobilization. Life, 13.","DOI":"10.3390\/life13010048"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"775","DOI":"10.1002\/nau.20592","article-title":"The relationship between subjective and objective assessments of sacral neuromodulation effectiveness in patients with urgency-frequency","volume":"27","author":"Peters","year":"2008","journal-title":"Neurourol. Urodyn."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"301","DOI":"10.1016\/0014-5793(93)80699-U","article-title":"Experimental evidence for 60 Hz magnetic fields operating through the signal transduction cascade. Effects on calcium influx and c-MYC mRNA induction","volume":"334","author":"Liburdy","year":"1993","journal-title":"FEBS Lett."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"325","DOI":"10.4172\/2165-7025.1000325","article-title":"Effect of Capacitive and Resistive Electric Transfer on Tissue Temperature, Muscle Flexibility, and Blood Circulation","volume":"7","author":"Yokota","year":"2017","journal-title":"J. Nov. Physiother."},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"Garc\u00eda-S\u00e1nchez, F.J., Mart\u00ednez-Vizca\u00edno, V., and Rodr\u00edguez-Mart\u00edn, B. (2019). Patients\u2019 and Caregivers\u2019 Conceptualisations of Pressure Ulcers and the Process of Decision-Making in the Context of Home Care. Int. J. Environ. Res. Public Health., 16.","DOI":"10.3390\/ijerph16152719"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"395","DOI":"10.47197\/retos.v46.93950","article-title":"\u00bfInfluyen las expectativas de los pacientes en el tratamiento conservador de la lumbalgia cr\u00f3nica? Una revisi\u00f3n narrativa (Do patients\u2019 expectations influence conservative treatment in Chronic Low Back Pain? A Narrative Review)","volume":"46","author":"Ballestra","year":"2022","journal-title":"Retos"},{"key":"ref_23","doi-asserted-by":"crossref","unstructured":"S\u00e1nchez Romero, E.A., Lim, T., Villafa\u00f1e, J.H., Boutin, G., Riquelme Aguado, V., Martin Pintado-Zugasti, A., Alonso P\u00e9rez, J.L., and Fern\u00e1ndez Carnero, J. (2021). The Influence of Verbal Suggestion on Post-Needling Soreness and Pain Processing after Dry Needling Treatment: An Experimental Study. Int. J. Environ. Res. Public Health, 18.","DOI":"10.3390\/ijerph18084206"},{"key":"ref_24","doi-asserted-by":"crossref","unstructured":"Vi\u00f1als Narv\u00e1ez, A.C., S\u00e1nchez-S\u00e1nchez, T., Garc\u00eda-Gonz\u00e1lez, M., Ardizone Garc\u00eda, I., Cid-Verdejo, R., S\u00e1nchez Romero, E.A., and Jim\u00e9nez-Ortega, L. (2023). Psychological and Behavioral Factors Involved in Temporomandibular Myalgia and Migraine: Common but Differentiated Profiles. Int. J. Environ. Res. Public Health, 20.","DOI":"10.3390\/ijerph20021545"},{"key":"ref_25","doi-asserted-by":"crossref","unstructured":"Osses-Anguita, \u00c1.E., S\u00e1nchez-S\u00e1nchez, T., Soto-Go\u00f1i, X.A., Garc\u00eda-Gonz\u00e1lez, M., Al\u00e9n Fari\u00f1as, F., Cid-Verdejo, R., S\u00e1nchez Romero, E.A., and Jim\u00e9nez-Ortega, L. (2023). Awake and Sleep Bruxism Prevalence and Their Associated Psychological Factors in First-Year University Students: A Pre-Mid-Post COVID-19 Pandemic Comparison. Int. J. Environ. Res. Public Health, 20.","DOI":"10.3390\/ijerph20032452"}],"container-title":["Medicina"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1648-9144\/59\/3\/516\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T18:49:32Z","timestamp":1760122172000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1648-9144\/59\/3\/516"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,3,7]]},"references-count":25,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2023,3]]}},"alternative-id":["medicina59030516"],"URL":"https:\/\/doi.org\/10.3390\/medicina59030516","relation":{},"ISSN":["1648-9144"],"issn-type":[{"type":"electronic","value":"1648-9144"}],"subject":[],"published":{"date-parts":[[2023,3,7]]}}}