Cambios físicos y metabólicos desencadenados tras la manipulación osteopática

ilustraciones

Autores:: Mendieta Melo, Rafael Alberto

Tipo de recurso:

Fecha de publicación:: 2023

Institución:: Universidad Nacional de Colombia

Repositorio:: Universidad Nacional de Colombia

Idioma:: spa

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dc.title.spa.fl_str_mv	Cambios físicos y metabólicos desencadenados tras la manipulación osteopática
dc.title.translated.eng.fl_str_mv	Physical and metabolic changes triggered by osteopathic manipulation
title	Cambios físicos y metabólicos desencadenados tras la manipulación osteopática
spellingShingle	Cambios físicos y metabólicos desencadenados tras la manipulación osteopática 610 - Medicina y salud::615 - Farmacología y terapéutica tratamientos complementarios manipulación osteopática terapéutica Complementary Therapies Manipulation, Osteopathic Therapeutics Osteopathy Osteopathic manipulation Effects Outcomes Osteopathic treatment Tratamiento osteopático Manipulación osteopática Efectos Cambios físicos Cambios metabólicos Biomecánica Inflamación Sistema nervioso autónomo
title_short	Cambios físicos y metabólicos desencadenados tras la manipulación osteopática
title_full	Cambios físicos y metabólicos desencadenados tras la manipulación osteopática
title_fullStr	Cambios físicos y metabólicos desencadenados tras la manipulación osteopática
title_full_unstemmed	Cambios físicos y metabólicos desencadenados tras la manipulación osteopática
title_sort	Cambios físicos y metabólicos desencadenados tras la manipulación osteopática
dc.creator.fl_str_mv	Mendieta Melo, Rafael Alberto
dc.contributor.advisor.none.fl_str_mv	Hernández Arévalo, Abel
dc.contributor.advisor.spa.fl_str_mv	Diaz Jiménez, Rafael
dc.contributor.author.spa.fl_str_mv	Mendieta Melo, Rafael Alberto
dc.subject.ddc.spa.fl_str_mv	610 - Medicina y salud::615 - Farmacología y terapéutica
topic	610 - Medicina y salud::615 - Farmacología y terapéutica tratamientos complementarios manipulación osteopática terapéutica Complementary Therapies Manipulation, Osteopathic Therapeutics Osteopathy Osteopathic manipulation Effects Outcomes Osteopathic treatment Tratamiento osteopático Manipulación osteopática Efectos Cambios físicos Cambios metabólicos Biomecánica Inflamación Sistema nervioso autónomo
dc.subject.decs.spa.fl_str_mv	tratamientos complementarios manipulación osteopática terapéutica
dc.subject.decs.eng.fl_str_mv	Complementary Therapies Manipulation, Osteopathic Therapeutics
dc.subject.proposal.eng.fl_str_mv	Osteopathy Osteopathic manipulation Effects Outcomes Osteopathic treatment
dc.subject.proposal.spa.fl_str_mv	Tratamiento osteopático Manipulación osteopática Efectos Cambios físicos Cambios metabólicos Biomecánica Inflamación Sistema nervioso autónomo
description	ilustraciones
publishDate	2023
dc.date.accessioned.none.fl_str_mv	2023-11-02T19:48:33Z
dc.date.available.none.fl_str_mv	2023-11-02T19:48:33Z
dc.date.issued.none.fl_str_mv	2023
dc.type.spa.fl_str_mv	Trabajo de grado - Maestría
dc.type.driver.spa.fl_str_mv	info:eu-repo/semantics/masterThesis
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dc.type.content.spa.fl_str_mv	Text
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status_str	acceptedVersion
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identifier_str_mv	Universidad Nacional de Colombia Repositorio Institucional Universidad Nacional de Colombia
dc.language.iso.spa.fl_str_mv	spa
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dc.relation.indexed.spa.fl_str_mv	Bireme
dc.relation.references.spa.fl_str_mv	Ajimsha, M. S., Al-Mudahka, N. R., & Al-Madzhar, J. A. (2015). Effectiveness of myofascial release: Systematic review of randomized controlled trials. Journal of Bodywork and Movement Therapies, 19(1), 102–112. https://doi.org/10.1016/j.jbmt.2014.06.001 Arienti, C., Farinola, F., Ratti, S., Daccò, S., & Fasulo, L. (2020). Variations of HRV and skin conductance reveal the influence of CV4 and Rib Raising techniques on autonomic balance: A randomized controlled clinical trial. Journal of Bodywork and Movement Therapies, 24(4), 395–401. https://doi.org/10.1016/j.jbmt.2020.07.002 Boff, T. A., Pasinato, F., Ben, Â. J., Bosmans, J. E., van Tulder, M., & Carregaro, R. L. (2020). Effectiveness of spinal manipulation and myofascial release compared with spinal manipulation alone on health-related outcomes in individuals with nonspecific low back pain: randomized controlled trial. Physiotherapy (United Kingdom), 107, 71–80. https://doi.org/10.1016/j.physio.2019.11.002 Buscemi, A., Pennisi, V., Rapisarda, A., Pennisi, A., & Coco, M. (2020). Efficacy of osteopathic treatment in patients with stable moderate-to-severe chronic obstructive pulmonary disease: A randomized controlled pilot study. Journal of Complementary and Integrative Medicine, 17(1). https://doi.org/10.1515/jcim-2018- 0128 Cicchitti, L., Martelli, M., & Cerritelli, F. (2015). Chronic inflammatory disease and osteopathy: A systematic review. In PLoS ONE (Vol. 10, Issue 3). Public Library of Science. https://doi.org/10.1371/journal.pone.0121327 De Las Peñas, C. F., Sohrbeck Campo, M., Fernández Carnero, J., & Miangolarra Page, J. C. (2005). Manual therapies in myofascial trigger point treatment: A systematic review. Journal of Bodywork and Movement Therapies, 9(1), 27–34. https://doi.org/10.1016/j.jbmt.2003.11.001 Franke, H., Fryer, G., Ostelo, R. W. J. G., & Kamper, S. J. (2015). Muscle energy technique for non-specific low-back pain. In Cochrane Database of Systematic Reviews (Vol. 2015, Issue 2). John Wiley and Sons Ltd. https://doi.org/10.1002/14651858.CD009852.pub2 Galindez-Ibarbengoetxea, X., Setuain, I., Andersen, L. L., Ramírez-Velez, R., González-Izal, M., Jauregi, A., & Izquierdo, M. (2017). Effects of cervical highvelocity low-amplitude techniques on range of motion, strength performance, and cardiovascular outcomes: A review. In Journal of Alternative and Complementary Medicine (Vol. 23, Issue 9, pp. 667–675). Mary Ann Liebert Inc. https://doi.org/10.1089/acm.2017.0002 González, I. (2009). Impacto de las técnicas manuales usadas en osteopatía sobre los propioceptores musculares: revisión de la literatura científica. Osteopatia Cientifica, 4(2), 70–75. https://doi.org/10.1016/S1886-9297(09)72210-6 Kovanur Sampath, K., Botnmark, E., Mani, R., David Cotter, J., Katare, R., Emani Munasinghe, P., & Tumilty, S. (2017). Neuro-endocrine Response Following a Thoracic Spinal Manipulation in Healthy Men. In Journal of Orthopaedic & Sports Physical Therapy® Downloaded from www.jospt.org at University of Hong Kong Libraries. www.jospt.org Licciardone, J. C., Stoll, S. T., Fulda, K. G., Russo, D. P., Siu, J., Winn, W., & Swift, J. (n.d.). Osteopathic Manipulative Treatment for Chronic Low Back Pain A Randomized Controlled Trial. In SPINE (Vol. 28, Issue 13). Manzotti, A., Cerritelli, F., Lombardi, E., La Rocca, S., Chiera, M., Galli, M., & Lista, G. (2020). Effects of osteopathic treatment versus static touch on heart rate and oxygen saturation in premature babies: A randomized controlled trial: OMT on physiological premature infants arousal: A RCT. Complementary Therapies in Clinical Practice, 39. https://doi.org/10.1016/j.ctcp.2020.101116 Mazzeo, S., Silverberg, C., Oommen, T., Moya, D., Angelo, N., Zwibel, H., Mancini, J., Leder, A., & Yao, S. C. (2020). Effects of osteopathic manipulative treatment on sleep quality in student athletes after concussion: A pilot study. Journal of the American Osteopathic Association, 120(9), 615–622. https://doi.org/10.7556/jaoa.2020.100 Miana, L., Hugo do Vale Bastos, V., Machado, S., Arias-Carrión, O., Nardi, A. E., Almeida, L., Ribeiro, P., Machado, D., King, H., & Silva, J. G. (2013). Changes in alpha band activity associated with application of the compression of fourth ventricular (CV-4) osteopathic procedure: A qEEG pilot study. Journal of Bodywork and Movement Therapies, 17(3), 291–296. https://doi.org/10.1016/j.jbmt.2012.10.002 Mills, M. V. (2021). The use of osteopathic manipulative treatment in the newborn nursery and its effect on health in the first six months of life: A retrospective observational case-control study. Complementary Therapies in Clinical Practice, 43. https://doi.org/10.1016/j.ctcp.2021.101357 Pizzolorusso, G., Turi, P., Barlafante, G., Cerritelli, F., Renzetti, C., Cozzolino, V., D’Orazio, M., Fusilli, P., Carinci, F., & D’Incecco, C. (2011). Effect of osteopathic manipulative treatment on gastrointestinal function and length of stay of preterm infants: An exploratory study. Chiropractic and Manual Therapies, 19. https://doi.org/10.1186/2045-709X-19-15 Plaza-Manzano, G., Molina, F., Lomas-Vega, R., Martínez- Amat, A., Achalandabaso, A., & Hita-Contreras, F. (2014). Changes in biochemical markers of pain perception and stress response after spinal manipulation. Journal of Orthopaedic and Sports Physical Therapy, 44(4), 231–239. https://doi.org/10.2519/jospt.2014.4996 Schwerla, F., Rother, K., Rother, D., Ruetz, M., & Resch, K. L. (2015). Osteopathic manipulative therapy in women with postpartum low back pain and disability: A pragmatic randomized controlled trial. Journal of the American Osteopathic Association, 115(7), 416–425. https://doi.org/10.7556/jaoa.2015.087 Tamburella, F., Piras, F., Piras, F., Spanò, B., Tramontano, M., & Gili, T. (2019). Cerebral perfusion changes after osteopathic manipulative treatment: A randomized manual placebo-controlled trial. Frontiers in Physiology, 10. https://doi.org/10.3389/fphys.2019.00403 Van Ravenswaay, V. J., Hain, S. J., Grasso, S., & Shubrook, J. H. (2015). Effects of osteopathic manipulative treatment on diabetic gastroparesis. Journal of the American Osteopathic Association, 115(7), 452–458. https://doi.org/10.7556/jaoa.2015.091 Vining, R., Onifer, S. M., Twist, E., Ziegler, A. M., Corber, L., & Long, C. R. (2022). Thoracolumbar fascia mobility and chronic low back pain: Phase 2 of a pilot and feasibility study including multimodal chiropractic care. Chiropractic and Manual Therapies, 30(1). https://doi.org/10.1186/s12998-022-00455-z Walkowski, S., Singh, M., Puertas, J., Pate, M., Goodrum, K., & Benencia, F. (2014). Osteopathic manipulative therapy induces early plasma cytokine release and mobilization of a population of blood dendritic cells. PLoS ONE, 9(3). https://doi.org/10.1371/journal.pone.0090132 Zanotti, E., Berardinelli, P., Bizzarri, C., Civardi, A., Manstretta, A., Rossetti, S., & Fracchia, C. (2012). Osteopathic manipulative treatment effectiveness in severe chronic obstructive pulmonary disease: A pilot study. Complementary Therapies in Medicine, 20(1–2), 16–22. https://doi.org/10.1016/j.ctim.2011.10.008
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dc.rights.license.spa.fl_str_mv	Atribución-NoComercial-SinDerivadas 4.0 Internacional
dc.rights.uri.spa.fl_str_mv	http://creativecommons.org/licenses/by-nc-nd/4.0/
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dc.format.extent.spa.fl_str_mv	40 páginas
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dc.publisher.program.spa.fl_str_mv	Bogotá - Medicina - Maestría en Medicina Alternativa
dc.publisher.faculty.spa.fl_str_mv	Facultad de Medicina
dc.publisher.place.spa.fl_str_mv	Bogotá, Colombia
dc.publisher.branch.spa.fl_str_mv	Universidad Nacional de Colombia - Sede Bogotá
institution	Universidad Nacional de Colombia
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repository.name.fl_str_mv	Repositorio Institucional Universidad Nacional de Colombia
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spelling	Atribución-NoComercial-SinDerivadas 4.0 Internacionalhttp://creativecommons.org/licenses/by-nc-nd/4.0/info:eu-repo/semantics/openAccesshttp://purl.org/coar/access_right/c_abf2Hernández Arévalo, Abel56fc7836b3e436e5fe4298646c5237f0Diaz Jiménez, Rafael2f5b40853d996857062b77b8962b681eMendieta Melo, Rafael Albertoc8d8ff657e70516a9b72908d9ecbf6c42023-11-02T19:48:33Z2023-11-02T19:48:33Z2023https://repositorio.unal.edu.co/handle/unal/84868Universidad Nacional de ColombiaRepositorio Institucional Universidad Nacional de Colombiahttps://repositorio.unal.edu.co/ilustracionesEl presente artículo es una revisión sistemática de la literatura existente sobre los cambios físicos y metabólicos que se producen tras la manipulación osteopática. Se realizó una búsqueda exhaustiva de estudios en las bases de datos PubMed, Medline, PEDro y Cochrane Library, encontrando 11 estudios que cumplían con los criterios de inclusión. Los estudios analizados evalúan los efectos de la manipulación osteopática en diferentes parámetros físicos y metabólicos, incluyendo la respuesta al dolor, la frecuencia cardiaca, la presión arterial, los niveles de glicemia y citoquinas, entre otros. Los resultados de la revisión mostraron que la manipulación osteopática puede tener efectos beneficiosos significativos, en la fuerza muscular, la reducción del dolor en diferentes regiones del cuerpo, en la frecuencia cardiaca, la presión arterial y la función respiratoria. En cuanto a los efectos metabólicos, esta revisión sistemática de la literatura sugiere que la manipulación osteopática puede tener efectos positivos significativos en diferentes parámetros, incluyendo la inflamación y la respuesta al dolor. Sin embargo, se necesitan más estudios bien diseñados para confirmar estos hallazgos y establecer los mecanismos subyacentes de estos efectos. (Texto tomado de la fuente).This article is a systematic review of the existing literature on the physical and metabolic changes that occur after osteopathic manipulation. A comprehensive search for studies was conducted in the PubMed, Medline, PEDro, and Cochrane Library databases, resulting in the identification of 11 studies that met the inclusion criteria. The analyzed studies assess the effects of osteopathic manipulation on various physical and metabolic parameters, including pain response, heart rate, blood pressure, blood glucose levels, and cytokines, among others. The review's findings showed that osteopathic manipulation may have significant beneficial effects on muscular strength, pain reduction in various body regions, heart rate, blood pressure, and respiratory function, although the findings are less consistent. Regarding metabolic effects, this systematic literature review suggests that osteopathic manipulation may have significant positive effects on various parameters, including inflammation and pain response. However, more well-designed studies are needed to confirm these findings and establish the underlying mechanisms of these effects.MaestríaMagíster en Medicina AlternativaTrabajo de investigación40 páginasapplication/pdfspa610 - Medicina y salud::615 - Farmacología y terapéuticatratamientos complementariosmanipulación osteopáticaterapéuticaComplementary TherapiesManipulation, OsteopathicTherapeuticsOsteopathyOsteopathic manipulationEffectsOutcomesOsteopathic treatmentTratamiento osteopáticoManipulación osteopáticaEfectosCambios físicosCambios metabólicosBiomecánicaInflamaciónSistema nervioso autónomoCambios físicos y metabólicos desencadenados tras la manipulación osteopáticaPhysical and metabolic changes triggered by osteopathic manipulationTrabajo de grado - Maestríainfo:eu-repo/semantics/masterThesisinfo:eu-repo/semantics/acceptedVersionTexthttp://purl.org/redcol/resource_type/TMBogotá - Medicina - Maestría en Medicina AlternativaFacultad de MedicinaBogotá, ColombiaUniversidad Nacional de Colombia - Sede BogotáBiremeAjimsha, M. S., Al-Mudahka, N. R., & Al-Madzhar, J. A. (2015). Effectiveness of myofascial release: Systematic review of randomized controlled trials. Journal of Bodywork and Movement Therapies, 19(1), 102–112. https://doi.org/10.1016/j.jbmt.2014.06.001Arienti, C., Farinola, F., Ratti, S., Daccò, S., & Fasulo, L. (2020). Variations of HRV and skin conductance reveal the influence of CV4 and Rib Raising techniques on autonomic balance: A randomized controlled clinical trial. Journal of Bodywork and Movement Therapies, 24(4), 395–401. https://doi.org/10.1016/j.jbmt.2020.07.002Boff, T. A., Pasinato, F., Ben, Â. J., Bosmans, J. E., van Tulder, M., & Carregaro, R. L. (2020). Effectiveness of spinal manipulation and myofascial release compared with spinal manipulation alone on health-related outcomes in individuals with nonspecific low back pain: randomized controlled trial. Physiotherapy (United Kingdom), 107, 71–80. https://doi.org/10.1016/j.physio.2019.11.002Buscemi, A., Pennisi, V., Rapisarda, A., Pennisi, A., & Coco, M. (2020). Efficacy of osteopathic treatment in patients with stable moderate-to-severe chronic obstructive pulmonary disease: A randomized controlled pilot study. Journal of Complementary and Integrative Medicine, 17(1). https://doi.org/10.1515/jcim-2018- 0128Cicchitti, L., Martelli, M., & Cerritelli, F. (2015). Chronic inflammatory disease and osteopathy: A systematic review. In PLoS ONE (Vol. 10, Issue 3). Public Library of Science. https://doi.org/10.1371/journal.pone.0121327De Las Peñas, C. F., Sohrbeck Campo, M., Fernández Carnero, J., & Miangolarra Page, J. C. (2005). Manual therapies in myofascial trigger point treatment: A systematic review. Journal of Bodywork and Movement Therapies, 9(1), 27–34. https://doi.org/10.1016/j.jbmt.2003.11.001Franke, H., Fryer, G., Ostelo, R. W. J. G., & Kamper, S. J. (2015). Muscle energy technique for non-specific low-back pain. In Cochrane Database of Systematic Reviews (Vol. 2015, Issue 2). John Wiley and Sons Ltd. https://doi.org/10.1002/14651858.CD009852.pub2Galindez-Ibarbengoetxea, X., Setuain, I., Andersen, L. L., Ramírez-Velez, R., González-Izal, M., Jauregi, A., & Izquierdo, M. (2017). Effects of cervical highvelocity low-amplitude techniques on range of motion, strength performance, and cardiovascular outcomes: A review. In Journal of Alternative and Complementary Medicine (Vol. 23, Issue 9, pp. 667–675). Mary Ann Liebert Inc. https://doi.org/10.1089/acm.2017.0002González, I. (2009). Impacto de las técnicas manuales usadas en osteopatía sobre los propioceptores musculares: revisión de la literatura científica. Osteopatia Cientifica, 4(2), 70–75. https://doi.org/10.1016/S1886-9297(09)72210-6Kovanur Sampath, K., Botnmark, E., Mani, R., David Cotter, J., Katare, R., Emani Munasinghe, P., & Tumilty, S. (2017). Neuro-endocrine Response Following a Thoracic Spinal Manipulation in Healthy Men. In Journal of Orthopaedic & Sports Physical Therapy® Downloaded from www.jospt.org at University of Hong Kong Libraries. www.jospt.orgLicciardone, J. C., Stoll, S. T., Fulda, K. G., Russo, D. P., Siu, J., Winn, W., & Swift, J. (n.d.). Osteopathic Manipulative Treatment for Chronic Low Back Pain A Randomized Controlled Trial. In SPINE (Vol. 28, Issue 13).Manzotti, A., Cerritelli, F., Lombardi, E., La Rocca, S., Chiera, M., Galli, M., & Lista, G. (2020). Effects of osteopathic treatment versus static touch on heart rate and oxygen saturation in premature babies: A randomized controlled trial: OMT on physiological premature infants arousal: A RCT. Complementary Therapies in Clinical Practice, 39. https://doi.org/10.1016/j.ctcp.2020.101116Mazzeo, S., Silverberg, C., Oommen, T., Moya, D., Angelo, N., Zwibel, H., Mancini, J., Leder, A., & Yao, S. C. (2020). Effects of osteopathic manipulative treatment on sleep quality in student athletes after concussion: A pilot study. Journal of the American Osteopathic Association, 120(9), 615–622. https://doi.org/10.7556/jaoa.2020.100Miana, L., Hugo do Vale Bastos, V., Machado, S., Arias-Carrión, O., Nardi, A. E., Almeida, L., Ribeiro, P., Machado, D., King, H., & Silva, J. G. (2013). Changes in alpha band activity associated with application of the compression of fourth ventricular (CV-4) osteopathic procedure: A qEEG pilot study. Journal of Bodywork and Movement Therapies, 17(3), 291–296. https://doi.org/10.1016/j.jbmt.2012.10.002Mills, M. V. (2021). The use of osteopathic manipulative treatment in the newborn nursery and its effect on health in the first six months of life: A retrospective observational case-control study. Complementary Therapies in Clinical Practice, 43. https://doi.org/10.1016/j.ctcp.2021.101357Pizzolorusso, G., Turi, P., Barlafante, G., Cerritelli, F., Renzetti, C., Cozzolino, V., D’Orazio, M., Fusilli, P., Carinci, F., & D’Incecco, C. (2011). Effect of osteopathic manipulative treatment on gastrointestinal function and length of stay of preterm infants: An exploratory study. Chiropractic and Manual Therapies, 19. https://doi.org/10.1186/2045-709X-19-15Plaza-Manzano, G., Molina, F., Lomas-Vega, R., Martínez- Amat, A., Achalandabaso, A., & Hita-Contreras, F. (2014). Changes in biochemical markers of pain perception and stress response after spinal manipulation. Journal of Orthopaedic and Sports Physical Therapy, 44(4), 231–239. https://doi.org/10.2519/jospt.2014.4996Schwerla, F., Rother, K., Rother, D., Ruetz, M., & Resch, K. L. (2015). Osteopathic manipulative therapy in women with postpartum low back pain and disability: A pragmatic randomized controlled trial. Journal of the American Osteopathic Association, 115(7), 416–425. https://doi.org/10.7556/jaoa.2015.087Tamburella, F., Piras, F., Piras, F., Spanò, B., Tramontano, M., & Gili, T. (2019). Cerebral perfusion changes after osteopathic manipulative treatment: A randomized manual placebo-controlled trial. Frontiers in Physiology, 10. https://doi.org/10.3389/fphys.2019.00403Van Ravenswaay, V. J., Hain, S. J., Grasso, S., & Shubrook, J. H. (2015). Effects of osteopathic manipulative treatment on diabetic gastroparesis. Journal of the American Osteopathic Association, 115(7), 452–458. https://doi.org/10.7556/jaoa.2015.091Vining, R., Onifer, S. M., Twist, E., Ziegler, A. M., Corber, L., & Long, C. R. (2022). Thoracolumbar fascia mobility and chronic low back pain: Phase 2 of a pilot and feasibility study including multimodal chiropractic care. Chiropractic and Manual Therapies, 30(1). https://doi.org/10.1186/s12998-022-00455-zWalkowski, S., Singh, M., Puertas, J., Pate, M., Goodrum, K., & Benencia, F. (2014). Osteopathic manipulative therapy induces early plasma cytokine release and mobilization of a population of blood dendritic cells. PLoS ONE, 9(3). https://doi.org/10.1371/journal.pone.0090132Zanotti, E., Berardinelli, P., Bizzarri, C., Civardi, A., Manstretta, A., Rossetti, S., & Fracchia, C. (2012). Osteopathic manipulative treatment effectiveness in severe chronic obstructive pulmonary disease: A pilot study. Complementary Therapies in Medicine, 20(1–2), 16–22. https://doi.org/10.1016/j.ctim.2011.10.008ConsejerosInvestigadoresPadres y familiasPúblico generalReceptores de fondos federales y solicitantesResponsables políticosLICENSElicense.txtlicense.txttext/plain; charset=utf-85879https://repositorio.unal.edu.co/bitstream/unal/84868/3/license.txteb34b1cf90b7e1103fc9dfd26be24b4aMD53ORIGINAL1054091951.2023.pdf1054091951.2023.pdfTesis de Maestría en Medicina Alternativaapplication/pdf564143https://repositorio.unal.edu.co/bitstream/unal/84868/4/1054091951.2023.pdfd69fcdf7ce43a540aa8620be9bd95908MD54THUMBNAIL1054091951.2023.pdf.jpg1054091951.2023.pdf.jpgGenerated Thumbnailimage/jpeg4866https://repositorio.unal.edu.co/bitstream/unal/84868/5/1054091951.2023.pdf.jpg341242a5d169820dec0e665b3167cc88MD55unal/84868oai:repositorio.unal.edu.co:unal/848682024-08-19 23:10:26.113Repositorio Institucional Universidad Nacional de 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