1
|
Bonavolontà V, Cianferotti L, Iolascon G, Moretti A, Brandi ML, Fischetti F, Lenzi A, Baldari C, Migliaccio S. Which physical activity in patients affected by hypoparathyroidism? A review of the literature and practical recommendations. J Endocrinol Invest 2022; 45:1289-1295. [PMID: 35122630 DOI: 10.1007/s40618-022-01756-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Accepted: 01/28/2022] [Indexed: 02/08/2023]
Abstract
BACKGROUND Hypoparathyroidism (HypoP) is a rare endocrine condition characterized by hypocalcaemia and hyperphosphatemia, as a consequence of absent or improperly low parathyroid hormone (PTH) levels. Patients affected by HypoP have a clinical condition often characterized by paresthesias and muscle spasms, as well as long-term consequences as nephrolithiasis, extraskeletal calcification, and fractures. In the literature, likely due to these symptoms, few data exist regarding the appropriate physical activity (PA) in subjects suffering from HypoP. PURPOSE This review evaluates the literature on exercise-based approaches to the management of individuals affected by HypoP and evaluates: (1) the effects of physical exercise on muscle cramps and other clinical symptoms; (2) the effects of exercise on PTH and calcium level; (3) the most suitable clinical exercise testing; and (4) the most suitable exercise combination. METHODS AND RESULTS A systematic search was conducted using the databases MEDLINE, Google Scholar using "hypoparathyroidism AND Physical Activity", "Training AND hypoparathyroidism", "Exercise AND muscle cramps", "Exercise AND Fatigue" as keywords. In addition, references list from the included articles were searched and cross-checked to identify any further potentially eligible studies. A total of 50 manuscripts were found among which 39 manuscripts were selected. A few clinical studies have been performed in HypoP patients to evaluate PA training protocols. CONCLUSION Although further research is needed to draw solid conclusions regarding best PA protocols in subjects affected by HypoP, a PA protocol has been proposed within the manuscript to encourage patients to attempt exercise to improve their clinical conditions and their quality of life.
Collapse
Affiliation(s)
- V Bonavolontà
- Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari "Aldo Moro", Bari, Italy
| | - L Cianferotti
- Bone Metabolic Diseases Unit, Department of Experimental and Clinical Biomedical Sciences, University of Firenze, Firenze, Italy
| | - G Iolascon
- Department of Medical and Surgical Specialties and Dentistry, University of Campania "Luigi Vanvitelli", Napoli, Italy
| | - A Moretti
- Department of Medical and Surgical Specialties and Dentistry, University of Campania "Luigi Vanvitelli", Napoli, Italy
| | | | - F Fischetti
- Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari "Aldo Moro", Bari, Italy
| | - A Lenzi
- Department of Experimental Medicine, Sapienza University of Roma, Roma, Italy
| | - C Baldari
- Department of Theoretical and Applied Sciences, eCampus University, Roma, Italy
| | - S Migliaccio
- Department of Movement, Human and Health Sciences, University Foro Italico of Roma, Piazza Lauro De Bosis 6, 00195, Roma, Italy.
| |
Collapse
|
2
|
Moretti A, Costa M, Beretta G. Would Moving Forward Mean Going Back? Comment on Maselli et al. Direct Access to Physical Therapy: Should Italy Move Forward? Int. J. Environ. Res. Public Health 2022, 19, 555. Int J Environ Res Public Health 2022; 19:ijerph19084579. [PMID: 35457446 PMCID: PMC9026379 DOI: 10.3390/ijerph19084579] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Revised: 04/30/2022] [Accepted: 04/06/2022] [Indexed: 02/05/2023]
Abstract
In a recent communication, Maselli and colleagues [...].
Collapse
Affiliation(s)
- Antimo Moretti
- Department of Medical and Surgical Specialties and Dentistry, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy
- Correspondence: ; Tel.: +39-0815665537
| | - Massimo Costa
- Physical and Rehabilitation Unit, AORN Vincenzo Cardarelli, 80131 Napoli, Italy;
| | - Giovanna Beretta
- Unit of Rehabilitation Medicine and Neurorehabilitation, Department of Neuroscience, ASST Niguarda Hospital, 20162 Milan, Italy;
| |
Collapse
|
3
|
Gimigliano F, Liguori S, Moretti A, Toro G, Rauch A, Negrini S, Iolascon G. A systematic review of Clinical Practice Guidelines for the management of fractures in children to develop the WHO's Package of Interventions for Rehabilitation. Eur J Phys Rehabil Med 2022; 58:236-241. [PMID: 34247473 PMCID: PMC9987461 DOI: 10.23736/s1973-9087.21.06916-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
INTRODUCTION Fractures have been identified as one of the 20 major health conditions for the World Health Organization's (WHO) Package of Interventions for Rehabilitation (PIR) - that includes also the needs of children and youth. The identification of existing interventions for rehabilitation and related evidence is a crucial step along the development of the PIR. The methods for the identification have been developed by WHO Rehabilitation Program and Cochrane Rehabilitation under the guidance of WHO's Guideline Review Committee Secretariat. EVIDENCE ACQUISITION This paper is part of the "Best Evidence for Rehabilitation" (be4rehab) series, developed according to the methodology presented in the PIR introductory paper. It is a systematic review of the existing Clinical Practice Guidelines (CPGs) on fractures in pediatric population published between 2009 to 2019. EVIDENCE SYNTHESIS We identified seven relevant CPGs after title and abstract screening. According to inclusion/exclusion criteria and after checking for quality, publication time, multidisciplinarity and comprehensiveness, we have been able to include two CPGs: one addresses the treatment of supracondylar humerus fractures and the other provides recommendations on the treatment of diaphyseal femur fractures. CONCLUSIONS The selected CPGs on the management of supracondylar humerus and diaphyseal femur fractures in pediatric population include few recommendations considered as interventions for rehabilitation, of low quality of evidence and weak strength. We found several gaps in specific rehabilitative topics. High quality studies are absolutely needed to upgrade the quality of available evidence to inform future development of guidelines.
Collapse
Affiliation(s)
- Francesca Gimigliano
- Department of Mental and Physical Health and Preventive Medicine, Luigi Vanvitelli University of Campania, Naples, Italy
| | - Sara Liguori
- Department of Medical and Surgical Specialties and Dentistry, Luigi Vanvitelli University of Campania, Naples, Italy -
| | - Antimo Moretti
- Department of Medical and Surgical Specialties and Dentistry, Luigi Vanvitelli University of Campania, Naples, Italy
| | - Giuseppe Toro
- Department of Medical and Surgical Specialties and Dentistry, Luigi Vanvitelli University of Campania, Naples, Italy
| | - Alexandra Rauch
- Unit of Sensory Functions, Disability and Rehabilitation, Department for Noncommunicable Diseases, World Health Organization, Geneva, Switzerland
| | - Stefano Negrini
- IRCCS Istituto Ortopedico Galeazzi, Milan, Italy
- Department of Biomedical, Surgical and Dental Sciences, La Statale University, Milan, Italy
| | - Giovanni Iolascon
- Department of Medical and Surgical Specialties and Dentistry, Luigi Vanvitelli University of Campania, Naples, Italy
| | | |
Collapse
|
4
|
Priadko K, Moretti A, Iolascon G, Gravina AG, Miranda A, Sgambato D, De Musis C, Romano M, Gimigliano F. Bone Alterations in Inflammatory Bowel Diseases: Role of Osteoprotegerin. J Clin Med 2022; 11:jcm11071840. [PMID: 35407448 PMCID: PMC8999800 DOI: 10.3390/jcm11071840] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Revised: 03/17/2022] [Accepted: 03/23/2022] [Indexed: 02/05/2023] Open
Abstract
Metabolic bone disorders are one of the most frequent extra-intestinal manifestations in patients with inflammatory bowel diseases (IBD) that might result in an increase of skeletal fragility and risk of fracture. These disorders are a consequence of bone−gut crosstalk alterations, particularly due to inflammation, which involves the RANK-RANKL-Osteoprotegerin (OPG) pathway. This cross-sectional study investigates the role of serum OPG on bone health in IBD patients. In all patients, we carried out BMD measurements at the lumbar spine and femoral neck by the dual-energy X-ray absorptiometry (DXA), and evaluation of serum OPG, 25(OH)D, and PTH. We also divided all IBD patients into two groups: group 1 consisted of premenopausal women and men younger than 50 years old, while group 2 included postmenopausal women and men aged more than 50 years old. We enrolled 36 UC patients (51%), 34 CD patients (49%), and 70 healthy controls. IBD group mean age was 44 ± 17.3 years old, with a mean disease duration of 6 years. IBD patients had a mean value of OPG of 48.1 ± 26.64 pg/mL, while mean OPG in the control group was 61.35 ± 47.19 pg/mL (p < 0.05). In group 1, there was a correlation between BMD Z-scores at the lumbar spine and femoral neck and mean OPG levels in UC subjects (r = 0.47 and r = −0.21, respectively; p < 0.05), and only between Z-score at the lumbar spine and OPG level in the CD group (r = 0.83, p < 0.05). For the patients of group 2, we report a statistically significant correlation between T-score measured at the lumbar site in both UC and CD patients (r = −0.79 and r = 0.77, respectively; p < 0.05). In our study, we demonstrated serum OPG levels to be significantly decreased in IBD subjects compared to healthy age-matched individuals. However, according to our data, it seems that the measurement of serum OPG levels is not useful to better define metabolic bone disorders in IBD patients.
Collapse
Affiliation(s)
- Kateryna Priadko
- Department of Precision Medicine and Hepato-Gastroenterology Unit, University Hospital and Università degli Studi della Campania “Luigi Vanvitelli”, 80138 Naples, Italy; (K.P.); (A.G.G.); (A.M.); (D.S.); (C.D.M.); (M.R.)
| | - Antimo Moretti
- Department of Medical and Surgical Specialties and Dentistry, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy;
- Correspondence: ; Tel.: +39-08-1566-5537
| | - Giovanni Iolascon
- Department of Medical and Surgical Specialties and Dentistry, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy;
| | - Antonietta Gerarda Gravina
- Department of Precision Medicine and Hepato-Gastroenterology Unit, University Hospital and Università degli Studi della Campania “Luigi Vanvitelli”, 80138 Naples, Italy; (K.P.); (A.G.G.); (A.M.); (D.S.); (C.D.M.); (M.R.)
| | - Agnese Miranda
- Department of Precision Medicine and Hepato-Gastroenterology Unit, University Hospital and Università degli Studi della Campania “Luigi Vanvitelli”, 80138 Naples, Italy; (K.P.); (A.G.G.); (A.M.); (D.S.); (C.D.M.); (M.R.)
| | - Dolores Sgambato
- Department of Precision Medicine and Hepato-Gastroenterology Unit, University Hospital and Università degli Studi della Campania “Luigi Vanvitelli”, 80138 Naples, Italy; (K.P.); (A.G.G.); (A.M.); (D.S.); (C.D.M.); (M.R.)
| | - Cristiana De Musis
- Department of Precision Medicine and Hepato-Gastroenterology Unit, University Hospital and Università degli Studi della Campania “Luigi Vanvitelli”, 80138 Naples, Italy; (K.P.); (A.G.G.); (A.M.); (D.S.); (C.D.M.); (M.R.)
| | - Marco Romano
- Department of Precision Medicine and Hepato-Gastroenterology Unit, University Hospital and Università degli Studi della Campania “Luigi Vanvitelli”, 80138 Naples, Italy; (K.P.); (A.G.G.); (A.M.); (D.S.); (C.D.M.); (M.R.)
| | - Francesca Gimigliano
- Department of Physical and Mental Health, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy;
| |
Collapse
|
5
|
Scaturro D, Guggino G, Terrana P, Vitagliani F, Falco V, Cuntrera D, Benedetti MG, Moretti A, Iolascon G, Letizia Mauro G. Rehabilitative interventions for ischaemic digital ulcers, pain, and hand functioning in systemic sclerosis: a prospective before-after study. BMC Musculoskelet Disord 2022; 23:193. [PMID: 35236311 PMCID: PMC8889643 DOI: 10.1186/s12891-022-05145-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Accepted: 01/12/2022] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Systemic sclerosis (SSc) is a rare connective tissue disease characterised by immune dysfunction, vasculopathy, cellular inflammation, fibrosis of the skin associated with multiple internal organs involvement. Ischaemic digital ulcers (IDU) of the hands commonly occur in patients with SSc adversely affecting functional independence. PURPOSE Aim of the study is to investigate the effectiveness of a rehabilitation protocol based on the combined use of ultrasound (US) therapy and therapeutic exercise in terms of ulcers healing, pain relief, and hand functioning in patients affected by SSc with IDUs. Moreover, we also investigated the safety of the proposed intervention. STUDY DESIGN Prospective before-after study. METHODS We included 20 patients with IDUs secondary to SSc. All patients were treated with US combined with manual therapy, including McMennel joint manipulation, pompage mobilization technique and connective tissue massage, for 10 sessions. We evaluated softness, dyschromia, pain, and hand mobility using the Pressure Sore Status Tool (PSST), the Numerical Rating Scale (NRS), and the Duruoz Hand Index (DHI) at T0 and at the end of the treatment (T1). RESULTS Treatment with US combined with manual therapy significantly reduced ulcers depth, improved ulcers margins, and reduced periwound skin damage (median PSST score 16 at T1, p<0.0001). Moreover, significant benefits were reported in terms of pain relief (NRS 3 at T1; p<0.0005), and hand function (DHI score 19 at T1; p<0.0005). Finally, this approach seems to be safe, without side effects reported at the end of treatment, along with an optimal compliance. CONCLUSION Therapeutic US combined with manual therapy should be used as additional intervention to manage IDUs in SSc patients.
Collapse
Affiliation(s)
- Dalila Scaturro
- grid.10776.370000 0004 1762 5517Department of Surgical, Oncological and Stomatological Disciplines, University of Palermo, Palermo, Italy
| | - Giuliana Guggino
- grid.412510.30000 0004 1756 3088Rheumatology section, Biomedical department of Internal Medicine, University Hospital “P.Giaccone”, Palermo, Italy
| | - Pietro Terrana
- grid.10776.370000 0004 1762 5517University of Palermo, Palermo, Italy
| | - Fabio Vitagliani
- grid.8158.40000 0004 1757 1969University of Catania, Catania, Italy
| | - Vincenzo Falco
- grid.10776.370000 0004 1762 5517Department of Economics and Statistics, University of Palermo, Palermo, Italy
| | - Daniele Cuntrera
- grid.10776.370000 0004 1762 5517Department of Economics and Statistics, University of Palermo, Palermo, Italy
| | - Maria Grazia Benedetti
- grid.6292.f0000 0004 1757 1758IRCCS-Istituto Ortopedico Rizzoli- University of Bologna, Bologna, Italy
| | - Antimo Moretti
- grid.9841.40000 0001 2200 8888Department of Medical and Surgical Specialties and Dentistry, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy
| | - Giovanni Iolascon
- grid.9841.40000 0001 2200 8888Department of Medical and Surgical Specialties and Dentistry, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy
| | - Giulia Letizia Mauro
- grid.10776.370000 0004 1762 5517Department of Surgical, Oncological and Stomatological Disciplines, University of Palermo, Palermo, Italy
| |
Collapse
|
6
|
Iolascon G, Moretti A. What are the efficacy and safety of pharmacological interventions versus placebo, no treatment or usual care for osteoporosis in people with chronic kidney disease stages 3-5D? - A Cochrane Review summary with commentary. J Musculoskelet Neuronal Interact 2022; 22:1-4. [PMID: 35234153 PMCID: PMC8919666 DOI: pmid/35234153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Affiliation(s)
- Giovanni Iolascon
- Department of Medical and Surgical Specialties and Dentistry, University of Campania “Luigi Vanvitelli”, Italy
| | - Antimo Moretti
- Department of Medical and Surgical Specialties and Dentistry, University of Campania “Luigi Vanvitelli”, Italy
- Corresponding author: Antimo Moretti, via De Crecchio, 4 - 80138 Naples, Italy E-mail:
| |
Collapse
|
7
|
Iolascon G, Tarantino U, Moretti A. Challenges and Solutions for Musculoskeletal Disorders in Athletes. Medicina (Kaunas) 2022; 58:80. [PMID: 35056388 PMCID: PMC8781726 DOI: 10.3390/medicina58010080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Accepted: 01/04/2022] [Indexed: 02/05/2023]
Abstract
The etymology of the word "athlete" derives from the ancient Greek ἀθλητής (athletés, from âthlos that is, fight, competition) [...].
Collapse
Affiliation(s)
- Giovanni Iolascon
- Department of Medical and Surgical Specialties and Dentistry, University of Campania “Luigi Vanvitelli”, 80100 Naples, Italy;
| | - Umberto Tarantino
- Department of Clinical Sciences and Translational Medicine, Faculty of Medicine and Surgery, “Tor Vergata” University of Rome, Via Montpellier 1, 00133 Rome, Italy;
| | - Antimo Moretti
- Department of Medical and Surgical Specialties and Dentistry, University of Campania “Luigi Vanvitelli”, 80100 Naples, Italy;
| |
Collapse
|
8
|
Moretti A. What are the efficacy and safety of bisphosphonates and RANK-ligand-inhibitors for men with prostate cancer and bone metastases? - A Cochrane Review summary with commentary. J Musculoskelet Neuronal Interact 2021; 21:451-454. [PMID: 34854383 PMCID: PMC8672400 DOI: pmid/34854383] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Affiliation(s)
- Antimo Moretti
- Department of Medical and Surgical Specialties and Dentistry, University of Campania “Luigi Vanvitelli”, Italy
- Corresponding author: Antimo Moretti, Department of Medical and Surgical Specialties and Dentistry, University of Campania “Luigi Vanvitelli”, Italy E-mail:
| |
Collapse
|
9
|
Moretti A, Palomba A, Paoletta M, Liguori S, Toro G, Iolascon G. Complex Regional Pain Syndrome in Athletes: Scoping Review. Medicina (Kaunas) 2021; 57:medicina57111262. [PMID: 34833480 PMCID: PMC8623027 DOI: 10.3390/medicina57111262] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Revised: 11/10/2021] [Accepted: 11/15/2021] [Indexed: 02/05/2023]
Abstract
Background and Objectives: Complex regional pain syndrome (CRPS) is a chronic condition characterized by disproportionate regional pain, usually affecting distal limbs, that follows trauma or surgery. Athletes may develop CRPS because of exposure to traumatic or overuse injuries. The aim of the present study is to review the available literature about CRPS type 1 in athletes. Materials and Methods: We searched two online databases (PubMed and Web of Science), selecting papers aiming at investigating CRPS type 1 (algodystrophy) in athletes. The analysis of databases was made considering original articles published until 30 June 2021, written in English. Results: Fifteen papers (12 case reports, 3 case series) were selected for a total of 20 clinical cases (15 females, 5 males), aged between 10 and 46 years (mean age 18.4 ± 9.8 standard deviation years). Patients included practiced different types of sport (soccer, athletics, gymnastics, basketball). The most involved anatomical sites were lower limbs, and time to diagnosis ranged from 2 days to 4 years. The most used treatments were pharmacological and physical therapies, but sometimes invasive approaches, as regional nerve, or lumbar sympathetic blocks, were provided. The main assessed outcomes were return to activity and pain. Conclusions: Our review suggests a higher prevalence of CRPS type 1 in younger people and in lower limbs than in general population but confirms the higher prevalence in females. However, the number of studies addressing CRPS in athletes is limited, as well as the number of involved patients, considering that only few and heterogeneous case reports were published about this topic. Moreover, the high prevalence of old studies (only 5 available studies in the last 10 years) might have influenced the choice of both assessment tools and management strategies. Despite these limitations, athletes showing disproportionate pain after sport-related injury should be promptly evaluated and treated through a multidimensional approach to avoid long-term consequences of algodystrophy.
Collapse
|
10
|
Letizia Mauro G, Scaturro D, Gimigliano F, Paoletta M, Liguori S, Toro G, Iolascon G, Moretti A. Physical Agent Modalities in Early Osteoarthritis: A Scoping Review. Medicina (Kaunas) 2021; 57:medicina57111165. [PMID: 34833383 PMCID: PMC8619194 DOI: 10.3390/medicina57111165] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Revised: 10/22/2021] [Accepted: 10/25/2021] [Indexed: 02/05/2023]
Abstract
Early osteoarthritis (EOA) still represents a challenge for clinicians. Although there is no consensus on its definition and diagnosis, a prompt therapeutic intervention in the early stages can have a significant impact on function and quality of life. Exercise remains a core treatment for EOA; however, several physical modalities are commonly used in this population. The purpose of this paper is to investigate the role of physical agents in the treatment of EOA. A technical expert panel (TEP) of 8 medical specialists with expertise in physical agent modalities and musculoskeletal conditions performed the review following the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews) model. The TEP searched for evidence of the following physical modalities in the management of EOA: "Electric Stimulation Therapy", "Pulsed Electromagnetic field", "Low-Level Light Therapy", "Laser Therapy", "Magnetic Field Therapy", "Extracorporeal Shockwave Therapy", "Hyperthermia, Induced", "Cryotherapy", "Vibration therapy", "Whole Body Vibration", "Physical Therapy Modalities". We found preclinical and clinical data on transcutaneous electrical nerve stimulation (TENS), extracorporeal shockwave therapy (ESWT), low-intensity pulsed ultrasound (LIPUS), pulsed electromagnetic fields stimulation (PEMF), and whole-body vibration (WBV) for the treatment of knee EOA. We found two clinical studies about TENS and PEMF and six preclinical studies-three about ESWT, one about WBV, one about PEMF, and one about LIPUS. The preclinical studies demonstrated several biological effects on EOA of physical modalities, suggesting potential disease-modifying effects. However, this role should be better investigated in further clinical studies, considering the limited data on the use of these interventions for EOA patients.
Collapse
Affiliation(s)
- Giulia Letizia Mauro
- Department of Surgery, Oncology, and Stomatology, University of Palermo, 90133 Palermo, Italy; (G.L.M.); (D.S.)
| | - Dalila Scaturro
- Department of Surgery, Oncology, and Stomatology, University of Palermo, 90133 Palermo, Italy; (G.L.M.); (D.S.)
| | - Francesca Gimigliano
- Department of Physical and Mental Health and Preventive Medicine, University of Campania “Luigi Vanvitelli”, 80100 Naples, Italy;
| | - Marco Paoletta
- Department of Medical and Surgical Specialties and Dentistry, University of Campania “Luigi Vanvitelli”, 80100 Naples, Italy; (S.L.); (G.T.); (G.I.); (A.M.)
- Correspondence: ; Tel.: +39-081-566-5537
| | - Sara Liguori
- Department of Medical and Surgical Specialties and Dentistry, University of Campania “Luigi Vanvitelli”, 80100 Naples, Italy; (S.L.); (G.T.); (G.I.); (A.M.)
| | - Giuseppe Toro
- Department of Medical and Surgical Specialties and Dentistry, University of Campania “Luigi Vanvitelli”, 80100 Naples, Italy; (S.L.); (G.T.); (G.I.); (A.M.)
| | - Giovanni Iolascon
- Department of Medical and Surgical Specialties and Dentistry, University of Campania “Luigi Vanvitelli”, 80100 Naples, Italy; (S.L.); (G.T.); (G.I.); (A.M.)
| | - Antimo Moretti
- Department of Medical and Surgical Specialties and Dentistry, University of Campania “Luigi Vanvitelli”, 80100 Naples, Italy; (S.L.); (G.T.); (G.I.); (A.M.)
| |
Collapse
|
11
|
Gimigliano F, Resmini G, Moretti A, Aulicino M, Gargiulo F, Gimigliano A, Liguori S, Paoletta M, Iolascon G. Epidemiology of Musculoskeletal Injuries in Adult Athletes: A Scoping Review. Medicina (Kaunas) 2021; 57:medicina57101118. [PMID: 34684155 PMCID: PMC8539527 DOI: 10.3390/medicina57101118] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Revised: 10/06/2021] [Accepted: 10/14/2021] [Indexed: 02/05/2023]
Abstract
Background and Objectives: Sport-related musculoskeletal injuries (MSK-Is) are a common health issue in athletes that can lead to reduced performance. The aim of this scoping review was to synthetize available evidence on injury incidence rates (IIRs), types, and sites that affect the musculoskeletal (MSK) system of adult athletes. Materials and Methods: We performed a scoping review on the Pubmed database limiting our search to 33 Olympic sports. Results: We identified a total of 1022 papers, and of these 162 were examined in full for the purpose of this review. Archery was the sport with the highest risk of injuries to the upper extremities, marathons for the lower extremities, and triathlon and weightlifting for the body bust. In the majority of the sports examined, muscle/tendon strain and ligament sprain were the most common MSK-Is diagnoses, while athletics, karate, and football were the sports with the highest IIRs, depending on the methods used for their calculations. Conclusions: Our scoping review highlighted the general lack and dishomogeneity in the collection of data on MSK-Is in athletes.
Collapse
Affiliation(s)
- Francesca Gimigliano
- Department of Mental and Physical Health and Preventive Medicine, University of Campania Luigi Vanvitelli, 81100 Naples, Italy;
| | - Giuseppina Resmini
- Centre for the Study of Osteoporosis and Metabolic Bone Disease, Section of Orthopaedic and Traumatology, Treviglio-Caravaggio Hospital, 24047 Bergamo, Italy;
| | - Antimo Moretti
- Department of Medical and Surgical Specialties and Dentistry, University of Campania Luigi Vanvitelli, 81100 Naples, Italy; (M.A.); (F.G.); (S.L.); (M.P.); (G.I.)
- Correspondence: ; Tel.: +39-081-566-5537
| | - Milena Aulicino
- Department of Medical and Surgical Specialties and Dentistry, University of Campania Luigi Vanvitelli, 81100 Naples, Italy; (M.A.); (F.G.); (S.L.); (M.P.); (G.I.)
| | - Fiorinda Gargiulo
- Department of Medical and Surgical Specialties and Dentistry, University of Campania Luigi Vanvitelli, 81100 Naples, Italy; (M.A.); (F.G.); (S.L.); (M.P.); (G.I.)
| | | | - Sara Liguori
- Department of Medical and Surgical Specialties and Dentistry, University of Campania Luigi Vanvitelli, 81100 Naples, Italy; (M.A.); (F.G.); (S.L.); (M.P.); (G.I.)
| | - Marco Paoletta
- Department of Medical and Surgical Specialties and Dentistry, University of Campania Luigi Vanvitelli, 81100 Naples, Italy; (M.A.); (F.G.); (S.L.); (M.P.); (G.I.)
| | - Giovanni Iolascon
- Department of Medical and Surgical Specialties and Dentistry, University of Campania Luigi Vanvitelli, 81100 Naples, Italy; (M.A.); (F.G.); (S.L.); (M.P.); (G.I.)
| |
Collapse
|
12
|
Crimaldi S, Liguori S, Tamburrino P, Moretti A, Paoletta M, Toro G, Iolascon G. The Role of Hyaluronic Acid in Sport-Related Tendinopathies: A Narrative Review. Medicina (Kaunas) 2021; 57:medicina57101088. [PMID: 34684125 PMCID: PMC8537182 DOI: 10.3390/medicina57101088] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Revised: 09/20/2021] [Accepted: 10/04/2021] [Indexed: 02/05/2023]
Abstract
Tendinopathy is a complex clinical condition with a rising incidence and prevalence, particularly during sports practice. For the return to play in affected patients, adequate functional and structural recovery of the tendon is the ultimate goal, avoiding the high risk of recurrence. In this perspective, local therapies alongside exercise are showing promising results. Despite evidence suggesting hyaluronic acid (HA) injections as effective in the treatment of tendinopathy, current recommendations about the management of this condition do not include this intervention. HA seems to be an effective therapeutic option for the management of sport-related tendinopathies, but further studies with a larger sample size are needed to confirm available findings. In this narrative review, we analyzed available literature about the rationale of the use of HA in the management of tendon injury and, particularly, in sport-related tendinopathies.
Collapse
Affiliation(s)
- Sergio Crimaldi
- Humanitas Clinical and Research Center—IRCCS, 20900 Milan, Italy;
| | - Sara Liguori
- Department of Medical and Surgical Specialties and Dentistry, University of Campania “Luigi Vanvitelli”, 80100 Naples, Italy; (A.M.); (M.P.); (G.T.); (G.I.)
- Correspondence: ; Tel.: +39-081-566-5537
| | - Pasquale Tamburrino
- Azienda USL Frosinone—UOC Ortopedia e Traumatologia, 03100 Frosinone, Italy;
| | - Antimo Moretti
- Department of Medical and Surgical Specialties and Dentistry, University of Campania “Luigi Vanvitelli”, 80100 Naples, Italy; (A.M.); (M.P.); (G.T.); (G.I.)
| | - Marco Paoletta
- Department of Medical and Surgical Specialties and Dentistry, University of Campania “Luigi Vanvitelli”, 80100 Naples, Italy; (A.M.); (M.P.); (G.T.); (G.I.)
| | - Giuseppe Toro
- Department of Medical and Surgical Specialties and Dentistry, University of Campania “Luigi Vanvitelli”, 80100 Naples, Italy; (A.M.); (M.P.); (G.T.); (G.I.)
| | - Giovanni Iolascon
- Department of Medical and Surgical Specialties and Dentistry, University of Campania “Luigi Vanvitelli”, 80100 Naples, Italy; (A.M.); (M.P.); (G.T.); (G.I.)
| |
Collapse
|
13
|
Iolascon G, Moretti A. Myths and Truths about Placebo Effect in Rehabilitation for Musculoskeletal Pain. Adv Ther 2021; 38:4995-5001. [PMID: 34476754 PMCID: PMC8478741 DOI: 10.1007/s12325-021-01894-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Accepted: 08/12/2021] [Indexed: 02/08/2023]
Abstract
This commentary provides the authors' point of view about the biopsychosocial perspective of placebo effect on musculoskeletal pain in the rehabilitation field.
Collapse
Affiliation(s)
- Giovanni Iolascon
- Department of Medical and Surgical Specialties and Dentistry, University of Campania Luigi Vanvitelli, Via de Crecchio, 6, 80138, Naples, Italy.
| | - Antimo Moretti
- Department of Medical and Surgical Specialties and Dentistry, University of Campania Luigi Vanvitelli, Via de Crecchio, 6, 80138, Naples, Italy
| |
Collapse
|
14
|
Paoletta M, Moretti A, Liguori S, Snichelotto F, Menditto I, Toro G, Gimigliano F, Iolascon G. Ultrasound Imaging in Sport-Related Muscle Injuries: Pitfalls and Opportunities. Medicina (Kaunas) 2021; 57:medicina57101040. [PMID: 34684077 PMCID: PMC8540210 DOI: 10.3390/medicina57101040] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Revised: 09/22/2021] [Accepted: 09/27/2021] [Indexed: 02/05/2023]
Abstract
Muscle injuries occur frequently in athletes, accounting for more than one-third of sport-related trauma. Athletes most affected by these injuries are those practicing football and track and field, with hamstrings and gastrocnemius-soleus as the mainly involved sites. Muscle injuries lead to loss of competitions, long recovery times and risk of re-injury with a consequent increase of the management costs. It is therefore advisable to make an accurate and timely diagnosis to establish appropriate interventions for proper healing in the shortest time. In this context, ultrasound imaging is widely used for diagnosis of musculoskeletal disorders because of several advantages including absence of radiation, portability, good spatial resolution, and the ability to perform dynamic tests. The aim of this review is to address the role of US in the evaluation of athletes with muscle injuries. US may play a pivotal role for the management of sport-related muscle injuries because it is fast and relatively cheap, allowing dynamic muscle assessment and time series evaluation of the healing process.
Collapse
Affiliation(s)
- Marco Paoletta
- Department of Medical and Surgical Specialties and Dentistry, University of Campania Luigi Vanvitelli, 80138 Naples, Italy; (M.P.); (S.L.); (F.S.); (I.M.); (G.T.); (G.I.)
| | - Antimo Moretti
- Department of Medical and Surgical Specialties and Dentistry, University of Campania Luigi Vanvitelli, 80138 Naples, Italy; (M.P.); (S.L.); (F.S.); (I.M.); (G.T.); (G.I.)
- Correspondence: ; Tel.: +39-081-566-5537
| | - Sara Liguori
- Department of Medical and Surgical Specialties and Dentistry, University of Campania Luigi Vanvitelli, 80138 Naples, Italy; (M.P.); (S.L.); (F.S.); (I.M.); (G.T.); (G.I.)
| | - Francesco Snichelotto
- Department of Medical and Surgical Specialties and Dentistry, University of Campania Luigi Vanvitelli, 80138 Naples, Italy; (M.P.); (S.L.); (F.S.); (I.M.); (G.T.); (G.I.)
| | - Ilaria Menditto
- Department of Medical and Surgical Specialties and Dentistry, University of Campania Luigi Vanvitelli, 80138 Naples, Italy; (M.P.); (S.L.); (F.S.); (I.M.); (G.T.); (G.I.)
| | - Giuseppe Toro
- Department of Medical and Surgical Specialties and Dentistry, University of Campania Luigi Vanvitelli, 80138 Naples, Italy; (M.P.); (S.L.); (F.S.); (I.M.); (G.T.); (G.I.)
| | - Francesca Gimigliano
- Department of Mental and Physical Health and Preventive Medicine, University of Campania Luigi Vanvitelli, 81100 Naples, Italy;
| | - Giovanni Iolascon
- Department of Medical and Surgical Specialties and Dentistry, University of Campania Luigi Vanvitelli, 80138 Naples, Italy; (M.P.); (S.L.); (F.S.); (I.M.); (G.T.); (G.I.)
| |
Collapse
|
15
|
Iolascon G, Moretti A, Paoletta M, Liguori S, Di Munno O. Muscle Regeneration and Function in Sports: A Focus on Vitamin D. Medicina (Kaunas) 2021; 57:medicina57101015. [PMID: 34684052 PMCID: PMC8537590 DOI: 10.3390/medicina57101015] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Revised: 08/30/2021] [Accepted: 09/24/2021] [Indexed: 02/05/2023]
Abstract
Muscle is one of the main targets for the biological effects of vitamin D. This hormone modulates several functions of skeletal muscles, from development to tissue repair after injury, through genomic and non-genomic mechanisms. Vitamin D deficiency and supplementation seem to significantly affect muscle strength in different populations, including athletes, although optimal serum 25(OH)D3 level for sport performance has not been defined so far. Additionally, vitamin D deficiency results in myopathy characterized by fast-twitch fiber atrophy, fatty infiltration, and fibrosis. However, less is known about regenerative effects of vitamin D supplementation after sport-related muscle injuries. Vitamin D receptor (VDR) is particularly expressed in the embryonic mesoderm during intrauterine life and in satellite cells at all stages of life for recovery of the skeletal muscle after injury. Vitamin D supplementation enhances muscle differentiation, growth, and regeneration by increasing the expression of myogenic factors in satellite cells. The objective of this narrative review is to describe the role of vitamin D in sport-related muscle injury and tissue regeneration.
Collapse
Affiliation(s)
- Giovanni Iolascon
- Department of Medical and Surgical Specialties and Dentistry, University of Campania “Luigi Vanvitelli”, Via de Crecchio, 6, 80138 Naples, Italy; (G.I.); (M.P.); (S.L.)
| | - Antimo Moretti
- Department of Medical and Surgical Specialties and Dentistry, University of Campania “Luigi Vanvitelli”, Via de Crecchio, 6, 80138 Naples, Italy; (G.I.); (M.P.); (S.L.)
- Correspondence: ; Tel.: +39-0815665537
| | - Marco Paoletta
- Department of Medical and Surgical Specialties and Dentistry, University of Campania “Luigi Vanvitelli”, Via de Crecchio, 6, 80138 Naples, Italy; (G.I.); (M.P.); (S.L.)
| | - Sara Liguori
- Department of Medical and Surgical Specialties and Dentistry, University of Campania “Luigi Vanvitelli”, Via de Crecchio, 6, 80138 Naples, Italy; (G.I.); (M.P.); (S.L.)
| | - Ombretta Di Munno
- Rheumatology Unit, Department of Clinical and Experimental Medicine, University of Pisa, 56122 Pisa, Italy;
| |
Collapse
|
16
|
Paoletta M, Moretti A, Liguori S, Di Paola A, Tortora C, Argenziano M, Rossi F, Iolascon G. Role of the Endocannabinoid/Endovanilloid System in the Modulation of Osteoclast Activity in Paget's Disease of Bone. Int J Mol Sci 2021; 22:ijms221810158. [PMID: 34576321 PMCID: PMC8469971 DOI: 10.3390/ijms221810158] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2021] [Revised: 09/17/2021] [Accepted: 09/18/2021] [Indexed: 02/05/2023] Open
Abstract
The role of the endocannabinoid/endovanilloid (EC/EV) system in bone metabolism has recently received attention. Current literature evidences the modulation of osteoclasts and osteoblasts through the activation or inhibition of cannabinoid receptors in various pathological conditions with secondary involvement of bone tissue. However, this role is still unclear in primary bone diseases. Paget's disease of the bone (PDB) could be considered a disease model for analyzing the role of the EC/EV system on osteoclasts (OCs), speculating the potential use of specific agents targeting this system for managing metabolic bone disorders. The aim of the study is to analyze OCs expression of EC/EV system in patients with PDB and to compare OCs activity between this population and healthy people. Finally, we investigate whether specific agents targeting EC/EV systems are able to modulate OCs activity in this metabolic bone disorder. We found a significant increase in cannabinoid receptor type 2 (CB2) protein expression in patients with PDB, compared to healthy controls. Moreover, we found a significant reduction in multi-nucleated tartrate-resistant acid phosphatase (TRAP)-positive OCs and resorption areas after treatment with JWH-133. CB2 could be a molecular target for reducing the activity of OCs in PDB, opening new therapeutic scenarios for the management of this condition.
Collapse
Affiliation(s)
- Marco Paoletta
- Department of Medical and Surgical Specialties and Dentistry, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy; (M.P.); (S.L.); (G.I.)
| | - Antimo Moretti
- Department of Medical and Surgical Specialties and Dentistry, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy; (M.P.); (S.L.); (G.I.)
- Correspondence: ; Tel.: +39-08156-65537
| | - Sara Liguori
- Department of Medical and Surgical Specialties and Dentistry, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy; (M.P.); (S.L.); (G.I.)
| | - Alessandra Di Paola
- Department of Experimental Medicine, University of Campania “Luigi Vanvitelli”, S. Maria di Costantinopoli 16, 80138 Naples, Italy;
| | - Chiara Tortora
- Department of Woman, Child and General and Specialist Surgery, University of Campania “Luigi Vanvitelli”, L. De Crecchio 4, 80138 Naples, Italy; (C.T.); (M.A.); (F.R.)
| | - Maura Argenziano
- Department of Woman, Child and General and Specialist Surgery, University of Campania “Luigi Vanvitelli”, L. De Crecchio 4, 80138 Naples, Italy; (C.T.); (M.A.); (F.R.)
| | - Francesca Rossi
- Department of Woman, Child and General and Specialist Surgery, University of Campania “Luigi Vanvitelli”, L. De Crecchio 4, 80138 Naples, Italy; (C.T.); (M.A.); (F.R.)
| | - Giovanni Iolascon
- Department of Medical and Surgical Specialties and Dentistry, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy; (M.P.); (S.L.); (G.I.)
| |
Collapse
|
17
|
Moretti A, Gimigliano F, Paoletta M, Bertone M, Liguori S, Toro G, Iolascon G. Complex Regional Pain Syndrome Type I Following Non-Orthopedic Surgery: Case Report and Narrative Review. Diagnostics (Basel) 2021; 11:diagnostics11091596. [PMID: 34573938 PMCID: PMC8465880 DOI: 10.3390/diagnostics11091596] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Revised: 08/30/2021] [Accepted: 08/30/2021] [Indexed: 02/05/2023] Open
Abstract
Complex regional pain syndrome type I (CRPS I)-or algodystrophy-is a rare disease that usually occurs after a traumatic event. It is characterized by typical clinical findings such as severe and disabling pain disproportionate to the injury, functional limitations, as well as sensory and vasomotor alterations. However, some people do not report any injury associated with algodystrophy onset in personal history. We describe the management of an unusual case of CRPS I which occurred during the long-term follow-up of percutaneous transluminal coronary angioplasty (PTCA) and performed a narrative review of algodystrophy in non-orthopedic surgery. A clinical case of a 44-year-old man with a spontaneous onset of CRPS I of the right ankle is presented. He did not refer to history of any memorable significant trigger event. Approximately 5 months before the onset of clinical manifestations, he received a PTCA via the right femoral approach. We suppose an association between CRPS and this procedure and propose a possible pathophysiologic mechanism. The patient was treated with intramuscular neridronate, which resulted in significant pain relief and improved his quality of life. A comprehensive clinical and instrumental evaluation in patients with CRPS is challenging but mandatory for a correct diagnosis. An extensive analysis of patient history is important for identifying any potential trigger event, including non-orthopedic procedures. Bone scan could have a pivotal role for improving diagnostic sensitivity and specificity in CRPS I. Neridronate was a safe and effective therapeutic approach for this patient, confirming the results of the high-quality evidence available.
Collapse
Affiliation(s)
- Antimo Moretti
- Department of Medical and Surgical Specialties and Dentistry, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy; (A.M.); (M.B.); (S.L.); (G.T.); (G.I.)
| | - Francesca Gimigliano
- Department of Mental and Physical Health and Preventive Medicine, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy;
| | - Marco Paoletta
- Department of Medical and Surgical Specialties and Dentistry, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy; (A.M.); (M.B.); (S.L.); (G.T.); (G.I.)
- Correspondence:
| | - Matteo Bertone
- Department of Medical and Surgical Specialties and Dentistry, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy; (A.M.); (M.B.); (S.L.); (G.T.); (G.I.)
| | - Sara Liguori
- Department of Medical and Surgical Specialties and Dentistry, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy; (A.M.); (M.B.); (S.L.); (G.T.); (G.I.)
| | - Giuseppe Toro
- Department of Medical and Surgical Specialties and Dentistry, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy; (A.M.); (M.B.); (S.L.); (G.T.); (G.I.)
| | - Giovanni Iolascon
- Department of Medical and Surgical Specialties and Dentistry, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy; (A.M.); (M.B.); (S.L.); (G.T.); (G.I.)
| |
Collapse
|
18
|
Toro G, Santoro C, Ambrosio D, Landi G, Scilipoti M, Moretti A, Paoletta M, Liguori S, Schiavone Panni A, Picariello S, Iolascon G. Natural History of Scoliosis in Children with NF1: An Observation Study. Healthcare (Basel) 2021; 9:healthcare9070881. [PMID: 34356257 PMCID: PMC8303287 DOI: 10.3390/healthcare9070881] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Revised: 06/25/2021] [Accepted: 07/09/2021] [Indexed: 02/05/2023] Open
Abstract
(1) Background. Scoliosis is the most common musculoskeletal manifestation of Neurofibromatosis type 1 (NF1), and it might be dystrophic (D) or non-dystrophic (ND) depending on the presence of dysplastic changes of the spine. The aim of our study was to describe the characteristics and natural history of patients with NF1 and scoliosis. (2) Methods. We retrospectively reviewed records from patients with NF1 and scoliosis. Scoliosis was classified as D if at least two dystrophic changes were documented at imaging. (3) Results. Of the 438 patients reviewed, 43 fulfilled inclusion criteria; 17 were classified in D group and 26 in ND. The groups did not differ in age and localization of scoliosis curvature. Surgery was needed more often in D group, but the between-group difference was not significant. Male-to-female ratios of 3:1 and 4:1 were reported in surgically treated NF1 patients with ND and D scoliosis, respectively. (4) Conclusions. Our data suggests independently by the presence of dysplastic changes affecting the spine that males with NF1 are more often affected by scoliosis that requires surgery.
Collapse
Affiliation(s)
- Giuseppe Toro
- Department of Medical and Surgical Specialties and Dentistry, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy; (G.T.); (D.A.); (G.L.); (A.M.); (S.L.); (A.S.P.); (G.I.)
- Department of Clinical Sciences and Translational Medicine, University of Rome Tor Vergata, 00133 Rome, Italy
| | - Claudia Santoro
- Department of Woman, Child and of General and Specialised Surgery, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy; (C.S.); (M.S.); (S.P.)
- Department of Mental Health, Physical and Preventive Medicine, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy
| | - Daniele Ambrosio
- Department of Medical and Surgical Specialties and Dentistry, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy; (G.T.); (D.A.); (G.L.); (A.M.); (S.L.); (A.S.P.); (G.I.)
| | - Giovanni Landi
- Department of Medical and Surgical Specialties and Dentistry, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy; (G.T.); (D.A.); (G.L.); (A.M.); (S.L.); (A.S.P.); (G.I.)
| | - Martina Scilipoti
- Department of Woman, Child and of General and Specialised Surgery, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy; (C.S.); (M.S.); (S.P.)
| | - Antimo Moretti
- Department of Medical and Surgical Specialties and Dentistry, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy; (G.T.); (D.A.); (G.L.); (A.M.); (S.L.); (A.S.P.); (G.I.)
| | - Marco Paoletta
- Department of Medical and Surgical Specialties and Dentistry, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy; (G.T.); (D.A.); (G.L.); (A.M.); (S.L.); (A.S.P.); (G.I.)
- Correspondence:
| | - Sara Liguori
- Department of Medical and Surgical Specialties and Dentistry, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy; (G.T.); (D.A.); (G.L.); (A.M.); (S.L.); (A.S.P.); (G.I.)
| | - Alfredo Schiavone Panni
- Department of Medical and Surgical Specialties and Dentistry, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy; (G.T.); (D.A.); (G.L.); (A.M.); (S.L.); (A.S.P.); (G.I.)
| | - Stefania Picariello
- Department of Woman, Child and of General and Specialised Surgery, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy; (C.S.); (M.S.); (S.P.)
| | - Giovanni Iolascon
- Department of Medical and Surgical Specialties and Dentistry, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy; (G.T.); (D.A.); (G.L.); (A.M.); (S.L.); (A.S.P.); (G.I.)
| |
Collapse
|
19
|
Iolascon G, Gimigliano F, Di Pietro G, Moretti A, Paoletta M, Rivezzi M, Distante A, Piscitelli P. Personalized paths for physical activity: developing a person-centered quantitative function to determine a customized amount of exercise and enhancing individual commitment. BMC Sports Sci Med Rehabil 2021; 13:60. [PMID: 34078454 PMCID: PMC8170630 DOI: 10.1186/s13102-021-00282-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Accepted: 05/11/2021] [Indexed: 02/08/2023]
Abstract
BACKGROUND Non-Communicable Diseases (NCDs) are leading causes of mortality. These conditions are also known as chronic diseases of long duration and generally slow progression. Physical activity (PA) is a main factor to delay symptoms and consequences of NCDs. In last decades, reduced physical exercise has been observed across all ages. Despite educational campaigns aimed at modifying unhealthy habits, it is difficult to promote healthy lifestyles in general population. Poor interest, lack of motivation, as well as career and family commitments hinder people's participation in regular PA programs. In this study we propose a theoretical person-centred approach to actively involve general population in enhancing their opportunity to perform PA based on personalized needs and targets. METHODS We defined four profiles of baseline PA levels (inactive, moderately inactive, moderately active, and active people) by referring to Metabolic equivalents (METs) based on individual answers to General Practice Physical Activity Questionnaire (GPPAQ). RESULTS Based on the answers to the GPPAQ and by computing the related METs for each profile of baseline exercise levels, we developed an innovative person-centered web-based algorithm/function for enhancing and measuring PA participation in community settings. This function can compute evidence-based standardized profiles of participants, personalized goals of PA being functional to the purpose of maintaining or gaining health benefits, as well as the type and duration of PA needed to reach these goals. CONCLUSION It might be speculated that this approach would be a reliable method for increasing people's self-efficacy and population adherence to recommended levels of PA. However, this theoretical proposal requires to be implemented in further research.
Collapse
Affiliation(s)
- Giovanni Iolascon
- Department of Medical and Surgical Specialties and Dentistry, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Francesca Gimigliano
- Department of Mental and Physical Health and Preventive Medicine, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Gioconda Di Pietro
- Department of Medical and Surgical Specialties and Dentistry, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Antimo Moretti
- Department of Medical and Surgical Specialties and Dentistry, University of Campania "Luigi Vanvitelli", Naples, Italy.
| | - Marco Paoletta
- Department of Medical and Surgical Specialties and Dentistry, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Matteo Rivezzi
- Doctorate in Translational Medicine, University of Foggia, Foggia, Italy
| | - Alessandro Distante
- Euro Mediterranean Scientific Biomedical Institute, ISBEM, Bruxelles, Belgium
| | - Prisco Piscitelli
- Euro Mediterranean Scientific Biomedical Institute, ISBEM, Bruxelles, Belgium
- Staff UNESCO Chair on Health Education and Sustainable Development, Federico II University of Naples, Naples, Italy
| |
Collapse
|
20
|
Iolascon G, de Sire A, Curci C, Paoletta M, Liguori S, Calafiore D, Gimigliano F, Moretti A. Osteoporosis guidelines from a rehabilitation perspective: systematic analysis and quality appraisal using AGREE II. Eur J Phys Rehabil Med 2021; 57:273-279. [PMID: 33650841 DOI: 10.23736/s1973-9087.21.06581-3] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
INTRODUCTION People affected by osteoporosis and fragility fractures often report disability and poor health-related quality of life. Albeit rehabilitation has a crucial role in older people, post-menopausal women and other subjects with high risk of fragility fractures, the rehabilitation perspective has been poorly investigated in the available guidelines for osteoporosis. The aim of this systematic review was to systematically evaluate the quality of guidelines for osteoporosis from a rehabilitation perspective. EVIDENCE ACQUISITION On May 2020, we performed a systematic search on medical literature of all guidelines published in the last 10 years on PubMed, Pedro, and international guideline databases. The study selection was based on key terms "exercise," "physical activity" or "rehabilitation." All authors independently assessed the methodological quality through the Appraisal of Guidelines for Research and Evaluation (AGREE) II instrument, consisting of six domains (scope, stakeholder involvement, rigor and development, clarity of presentation, applicability, editorial independence). EVIDENCE SYNTHESIS Out of 331 documents retrieved, a total of 34 guidelines were selected after the screening phases. Twenty (58.8%) high quality guidelines were reported. According to AGREE II instrument, a mean score of 78.1±21.8% was reported for "scope and purpose" domain; for stakeholder involvement, the mean score was 58.1±22.1%; the rigor of development was good (mean score of 61.3±27.3%); for clarity of presentation the mean score was 79.4±20.3%; the applicability was poor (mean score of 30.9±25.2%); for editorial independence the mean score was 75.1±24.6%. Rehabilitation recommendations for osteoporotic patients were reported in 21 (61.8%) of the selected guidelines. CONCLUSIONS This is the first systematic analysis evaluating quality of the guidelines for osteoporosis using AGREE II instrument. Starting from a state of the art of the currently available evidence, we could conclude that therapeutic exercise at moderate to high intensity is encouraged by several guidelines for the management of people with osteoporosis and fragility fractures. More than half of guidelines were of high-quality. However, most guidelines are lacking specific indications about exercise features. This study might support the implementation of a rehabilitation perspective in the guidelines for osteoporotic patients.
Collapse
Affiliation(s)
- Giovanni Iolascon
- Department of Medical and Surgical Specialties and Dentistry, Luigi Vanvitelli University of Campania, Naples, Italy
| | - Alessandro de Sire
- Department of Medical and Surgical Sciences, University of Catanzaro "Magna Grecia", Catanzaro, Italy -
| | - Claudio Curci
- Section of Neuromotor Rehabilitation, Department of Neuroscience, ASST Carlo Poma, Mantua, Italy
| | - Marco Paoletta
- Department of Medical and Surgical Specialties and Dentistry, Luigi Vanvitelli University of Campania, Naples, Italy
| | - Sara Liguori
- Department of Medical and Surgical Specialties and Dentistry, Luigi Vanvitelli University of Campania, Naples, Italy
| | - Dario Calafiore
- Section of Neuromotor Rehabilitation, Department of Neuroscience, ASST Carlo Poma, Mantua, Italy
| | - Francesca Gimigliano
- Department of Mental and Physical Health and Preventive Medicine, Luigi Vanvitelli University of Campania, Naples, Italy
| | - Antimo Moretti
- Department of Medical and Surgical Specialties and Dentistry, Luigi Vanvitelli University of Campania, Naples, Italy
| |
Collapse
|
21
|
Cecoro G, Paoletta M, Annunziata M, Laino L, Nastri L, Gimigliano F, Liguori S, Toro G, Moretti A, Guida L, Iolascon G. The role of bone anabolic drugs in the management of periodontitis: a scoping review. Eur Cell Mater 2021; 41:316-331. [PMID: 33733451 DOI: 10.22203/ecm.v041a20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
The aim of this scoping review was to summarise current knowledge about the effects of bone anabolic drugs on periodontitis, in order to identify new therapeutic strategies for preventing disease progression and reducing tooth loss. A technical expert panel (TEP) was established of 11 medical specialists, including periodontists and bone specialists that followed the PRISMA-ScR model to perform the scoping review and considered for eligibility both pre-clinical and clinical studies published in the English language up to September 2020. 716 items were initially found. After duplicate removal and screening of articles for eligibility criteria, 25 articles published between 2001 and 2019 were selected. Only studies concerning teriparatide, strontium ranelate, sclerostin antibodies and DKK1 antibodies met the eligibility criteria. In particular, only for teriparatide were there both clinical studies and experimental studies available, while for other bone anabolic drugs only animal studies were found. Available evidence about the use of bone anabolic drugs in periodontology demonstrates beneficial effects of these agents on biological pathways and histological parameters involved in periodontal tissue regeneration that suggest relevant clinical implications for the management of periodontitis.
Collapse
Affiliation(s)
| | | | | | | | | | | | | | | | - A Moretti
- Department of Medical and Surgical Specialties and Dentistry, University of Campania "Luigi Vanvitelli", 80138 Naples,
| | | | | |
Collapse
|
22
|
Moretti A, Paoletta M, Liguori S, Ilardi W, Snichelotto F, Toro G, Gimigliano F, Iolascon G. The Rationale for the Intra-Articular Administration of Clodronate in Osteoarthritis. Int J Mol Sci 2021; 22:ijms22052693. [PMID: 33799992 PMCID: PMC7962069 DOI: 10.3390/ijms22052693] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Revised: 03/04/2021] [Accepted: 03/05/2021] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Several pharmacological therapeutic approaches have been proposed to manage osteoarthritis (OA), including intra-articular (IA) injections. Although the discovery of clodronate, a bisphosphonate, dates back to the 1960s and the effects of its IA administration have been investigated for decades in animal models, mechanisms of action of this drug are not quite clear, particularly in OA. This scoping review is an overview of the biological as well as the clinical role of clodronic acid in OA. METHOD A scoping review based on the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews) model was performed to characterize the mechanisms of action of IA clodronate in OA and to evaluate its efficacy from a clinical point of view. RESULTS Several effects of clodronate have been observed in animal models of OA, including depletion of synovial lining cells that results in reduced production of chemokines (IL-1, TNF- α), growth factors (TGF-β, BMP 2/4), and metalloproteases (MMP 2/3/9); prevention of cartilage damage, synovial hyperplasia, and proteoglycans loss; reduction in joint inflammation, joint swelling, and osteophyte formation. From a clinical perspective, patients with knee OA treated with IA clodronate experienced improvements in pain and joint mobility. CONCLUSION Clodronate appears to have different mechanisms of action interfering with the pathogenic processes contributing to OA development and progression. This intervention demonstrated positive effects for patients affected by knee OA.
Collapse
Affiliation(s)
- Antimo Moretti
- Department of Medical and Surgical Specialties and Dentistry, University of Campania “Luigi Vanvitelli”, 81100 Naples, Italy; (A.M.); (M.P.); (S.L.); (W.I.); (F.S.); (G.T.)
| | - Marco Paoletta
- Department of Medical and Surgical Specialties and Dentistry, University of Campania “Luigi Vanvitelli”, 81100 Naples, Italy; (A.M.); (M.P.); (S.L.); (W.I.); (F.S.); (G.T.)
| | - Sara Liguori
- Department of Medical and Surgical Specialties and Dentistry, University of Campania “Luigi Vanvitelli”, 81100 Naples, Italy; (A.M.); (M.P.); (S.L.); (W.I.); (F.S.); (G.T.)
| | - Walter Ilardi
- Department of Medical and Surgical Specialties and Dentistry, University of Campania “Luigi Vanvitelli”, 81100 Naples, Italy; (A.M.); (M.P.); (S.L.); (W.I.); (F.S.); (G.T.)
| | - Francesco Snichelotto
- Department of Medical and Surgical Specialties and Dentistry, University of Campania “Luigi Vanvitelli”, 81100 Naples, Italy; (A.M.); (M.P.); (S.L.); (W.I.); (F.S.); (G.T.)
| | - Giuseppe Toro
- Department of Medical and Surgical Specialties and Dentistry, University of Campania “Luigi Vanvitelli”, 81100 Naples, Italy; (A.M.); (M.P.); (S.L.); (W.I.); (F.S.); (G.T.)
| | - Francesca Gimigliano
- Department of Mental and Physical Health and Preventive Medicine, University of Campania Luigi Vanvitelli, 81100 Naples, Italy;
| | - Giovanni Iolascon
- Department of Medical and Surgical Specialties and Dentistry, University of Campania “Luigi Vanvitelli”, 81100 Naples, Italy; (A.M.); (M.P.); (S.L.); (W.I.); (F.S.); (G.T.)
- Correspondence: ; Tel.: +39-081-566-5538
| |
Collapse
|
23
|
Scaturro D, Rizzo S, Sanfilippo V, Giustino V, Messina G, Martines F, Falco V, Cuntrera D, Moretti A, Iolascon G, Letizia Mauro G. Effectiveness of Rehabilitative Intervention on Pain, Postural Balance, and Quality of Life in Women with Multiple Vertebral Fragility Fractures: A Prospective Cohort Study. J Funct Morphol Kinesiol 2021; 6:jfmk6010024. [PMID: 33802536 PMCID: PMC7931028 DOI: 10.3390/jfmk6010024] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2021] [Revised: 01/31/2021] [Accepted: 02/24/2021] [Indexed: 02/05/2023] Open
Abstract
Patients with vertebral fragility fractures often experience chronic pain, postural and balance disorders, and poor quality of life (QoL). Although several studies have investigated the role of rehabilitation in severe osteoporosis, the effectiveness of this intervention in patients with multiple vertebral fractures is poorly known. The aim of our longitudinal cohort study is to evaluate the effectiveness of rehabilitation, including postural training, resistance exercises, and visual stabilization exercises, for a 7-week period, on the pain, postural balance, and QoL of subjects with at least two vertebral fragility fractures receiving denosumab and vitamin D. We investigated, before (T0) and after (T1, at 7 weeks) rehabilitation, the following outcome measures on 28 patients: pain (Numerical Rating Scale (NRS)), self-perceived QoL (36-Item Short Form Survey (SF-36) and Mini-Osteoporosis Quality of Life Questionnaire (Mini-OQOL)), dizziness (Dizziness Handicap Inventory (DHI-I)), mobility (Timed-Up and Go (TUG) test), and instrumental posturographic assessment (FreeMed posturography system). At the end of the treatment, improvements of pain and QoL were recorded. Pain relief was highly obtained in patients with more than two vertebral fractures. Moreover, a significant functional improvement (TUG test) was found in those with two vertebral fractures, without any statistically significant change reported for other outcomes. Our findings suggest that combined intervention, including anti-osteoporotic drugs and postural rehabilitation, should be proposed to osteoporotic patients with multiple vertebral fractures.
Collapse
Affiliation(s)
- Dalila Scaturro
- Department of Oncology and Stomatological Surgical Disciplines, University of Palermo, 90100 Palermo, Italy; (D.S.); (S.R.); (V.S.); (G.L.M.)
| | - Serena Rizzo
- Department of Oncology and Stomatological Surgical Disciplines, University of Palermo, 90100 Palermo, Italy; (D.S.); (S.R.); (V.S.); (G.L.M.)
| | - Valeria Sanfilippo
- Department of Oncology and Stomatological Surgical Disciplines, University of Palermo, 90100 Palermo, Italy; (D.S.); (S.R.); (V.S.); (G.L.M.)
| | - Valerio Giustino
- Program in Health Promotion and Cognitive Sciences, Department of Psychology, Educational Science and Human Movement, University of Palermo, 90100 Palermo, Italy;
| | - Giuseppe Messina
- Department of Psychology, Educational Science and Human Movement, University of Palermo, 90100 Palermo, Italy;
- PosturaLab Italia Research Institute, 90100 Palermo, Italy
| | - Francesco Martines
- Istituto Euromediterraneo di Scienza e Tecnologia—IEMEST, 90100 Palermo, Italy;
- Bi.N.D. Department, Audiology Section, University of Palermo, 90100 Palermo, Italy
| | - Vincenzo Falco
- Department of Economics, Statistics University of Palermo, 90100 Palermo, Italy; (V.F.); (D.C.)
| | - Daniele Cuntrera
- Department of Economics, Statistics University of Palermo, 90100 Palermo, Italy; (V.F.); (D.C.)
| | - Antimo Moretti
- Department of Medical and Surgical Specialties and Dentistry, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy;
- Correspondence: ; Tel.: +39-081-566-5537
| | - Giovanni Iolascon
- Department of Medical and Surgical Specialties and Dentistry, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy;
| | - Giulia Letizia Mauro
- Department of Oncology and Stomatological Surgical Disciplines, University of Palermo, 90100 Palermo, Italy; (D.S.); (S.R.); (V.S.); (G.L.M.)
| |
Collapse
|
24
|
Moretti A. What is the role of magnesium for skeletal muscle cramps? A Cochrane Review summary with commentary. J Musculoskelet Neuronal Interact 2021; 21:1-3. [PMID: 33657750 PMCID: PMC8020016 DOI: pmid/33657750] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Affiliation(s)
- Antimo Moretti
- Department of Medical and Surgical Specialties and Dentistry, University of Campania “Luigi Vanvitelli”, Naples, Italy
- Corresponding author: Antimo Moretti, Department of Medical and Surgical Specialties and Dentistry, University of Campania “Luigi Vanvitelli”, Naples, Italy E-mail:
| |
Collapse
|
25
|
Gimigliano F, Liguori S, Moretti A, Toro G, Rauch A, Negrini S, Iolascon G. Correction to: Systematic review of clinical practice guidelines for adults with fractures: identification of best evidence for rehabilitation to develop the WHO's Package of Interventions for Rehabilitation. J Orthop Traumatol 2021; 22:7. [PMID: 33649874 PMCID: PMC7921260 DOI: 10.1186/s10195-021-00566-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Abstract
An amendment to this paper has been published and can be accessed via the original article.
Collapse
Affiliation(s)
- Francesca Gimigliano
- Department of Mental and Physical Health and Preventive Medicine, University of Campania "Luigi Vanvitelli", Largo Madonna delle Grazie n. 1, 80138, Naples, Italy
| | - Sara Liguori
- Department of Medical and Surgical Specialties and Dentistry, University of Campania "Luigi Vanvitelli", Via De Crecchio n.4, 80138, Naples, Italy.
| | - Antimo Moretti
- Department of Medical and Surgical Specialties and Dentistry, University of Campania "Luigi Vanvitelli", Via De Crecchio n.4, 80138, Naples, Italy
| | - Giuseppe Toro
- Department of Medical and Surgical Specialties and Dentistry, University of Campania "Luigi Vanvitelli", Via De Crecchio n.4, 80138, Naples, Italy
| | - Alexandra Rauch
- Rehabilitation Programme World Health Organization, Avenue Appia 20, 1211, Geneva 27, Switzerland
| | - Stefano Negrini
- IRCCS Istituto Ortopedico Galeazzi, Milan, Italy
- Department of Biomedical, Surgical, and Dental Sciences, University La Statale, Milan, Italy
| | | | - Giovanni Iolascon
- Department of Medical and Surgical Specialties and Dentistry, University of Campania "Luigi Vanvitelli", Via De Crecchio n.4, 80138, Naples, Italy
| |
Collapse
|
26
|
Moretti A, Gimigliano F, Paoletta M, Liguori S, Toro G, Aulicino M, Conversano S, Iolascon G. Efficacy and Effectiveness of Physical Agent Modalities in Complex Regional Pain Syndrome Type I: A Scoping Review. Applied Sciences 2021; 11:1857. [DOI: 10.3390/app11041857] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Complex regional pain syndrome type I (CRPS-I) is a rare condition with huge variability in triggering factors and clinical scenarios. The complexity of the pathophysiology of this condition fosters the proposal of several therapeutic options with different mechanisms of action in both research and clinical practice. An interdisciplinary and multimodal approach, including pharmacological and non-pharmacological interventions, particularly physical therapy, is recommended by international guidelines, but the benefits and harms of available interventions are poorly known. In this scoping review, the clinical rationale for use of physical agent modalities for patients with CRPS-I will be presented. We found 10 studies addressing the role of electromagnetic field therapy, electrotherapy, and laser therapy. Our findings suggest that physical therapy modalities, in particular transcutaneous electrical nerve stimulation (TENS) and pulsed electromagnetic field therapy (PEMF), may contribute to reduce pain and improve function in patients with CRPS-1.
Collapse
|
27
|
Liguori S, Moretti A, Paoletta M, Gimigliano F, Iolascon G. Rehabilitation of Neuromuscular Diseases During COVID-19: Pitfalls and Opportunities. Front Neurol 2021; 12:626319. [PMID: 33679588 PMCID: PMC7933194 DOI: 10.3389/fneur.2021.626319] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Accepted: 01/27/2021] [Indexed: 02/05/2023] Open
Abstract
The outbreak of COVID-19 caused by SARS-CoV-2 has spread worldwide with a huge impact on the healthcare system. Compared to the previous coronaviruses-related pandemics, COVID-19 is more transmissible with potential systemic involvement and peculiar neurological manifestations, such as Guillan-Barrè syndrome up to critical illness myopathy, occurring in the intensive care setting. In this clinical scenario, people living with a neuromuscular disease (NMD) represent a vulnerable category with a high risk of a severe course of COVID-19. Moreover, in the NMD population, the management of respiratory and muscular impairments after SARS-CoV-2 infection might be troubling in terms of both pharmacological and rehabilitative approaches. To date, rehabilitation is still an unmet need in this population with several implications on NMD progression with and without SARS-CoV-2 infection. In particular, rehabilitation intervention for patients with NMD after COVID-19 are lacking. Therefore, in the current paper, we analyze the critical issues of COVID-19 on NMDs patients and propose a home-based rehabilitation program targeted for this population after mild to moderate SARS-CoV-2 infection.
Collapse
Affiliation(s)
- Sara Liguori
- Department of Medical and Surgical Specialties and Dentistry, University of Campania “Luigi Vanvitelli”, Naples, Italy
| | - Antimo Moretti
- Department of Medical and Surgical Specialties and Dentistry, University of Campania “Luigi Vanvitelli”, Naples, Italy
| | - Marco Paoletta
- Department of Medical and Surgical Specialties and Dentistry, University of Campania “Luigi Vanvitelli”, Naples, Italy
| | - Francesca Gimigliano
- Department of Mental and Physical Health and Preventive Medicine, University of Campania “Luigi Vanvitelli”, Naples, Italy
| | - Giovanni Iolascon
- Department of Medical and Surgical Specialties and Dentistry, University of Campania “Luigi Vanvitelli”, Naples, Italy
| |
Collapse
|
28
|
Migliore A, Gigliucci G, Moretti A, Pietrella A, Peresson M, Atzeni F, Sarzi-Puttini P, Bazzichi L, Liguori S, Iolascon G. Cross Cultural Adaptation and Validation of Italian Version of the Leeds Assessment of Neuropathic Symptoms and Signs Scale and Pain DETECT Questionnaire for the Distinction between Nociceptive and Neuropathic Pain. Pain Res Manag 2021; 2021:6623651. [PMID: 34012496 PMCID: PMC8102124 DOI: 10.1155/2021/6623651] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Revised: 03/12/2021] [Accepted: 04/19/2021] [Indexed: 02/08/2023]
Abstract
OBJECTIVE This study aimed to validate Italian versions of Leeds Assessment of Neuropathic Symptoms and Signs (LANSS) scale and Pain DETECT questionnaire (PD-Q) and evaluate the ability of these questionnaires to discriminate between nociceptive and neuropathic pain. DESIGN Multicenter prospective validation cohort study. Subjects and Setting. One hundred patients were included with a diagnosis formulated by a specialist in outpatient settings (50 affected by knee osteoarthritis as nociceptive pain and 50 affected by trigeminal or postherpetic neuralgia as neuropathic pain). METHODS The Italian versions of both questionnaires according to Italian cultural characteristics were performed according to the following steps: (1) translation of the questionnaires from English into Italian; (2) review by a bilingual individual for consistency; (3) proposed version after a mail round between experts; (4) backward translation; (5) comparison with the original English version by the experts; (6) approved version of the questionnaires. One hundred patients were enrolled and completed the two questionnaires administered by a specialist or blinded nursing staff, at the baseline and after 24/48 hours. Internal consistency, stability, validity, and discriminative power were analyzed. RESULTS Statistically significant differences were reported about the ability of both questionnaires to discriminate between patients affected by neuropathic or nociceptive pain. Internal consistency for the Italian version of the LANSS was 0.76, and for PD-Q, it was 0.80, assessed by Cronbach's α; LANSS showed a good test-retest reliability with an ICC of 0.76, and PD-Q showed a high test-retest reliability with an ICC of 0.96. For interrater reliability, there was a concordance rate of 83.3% between reference diagnosis and LANSS (Cohen's kappa = 0.67, CI 95% 0.52-0.75). CONCLUSIONS This study validated the Italian versions of LANSS and PD-Q as reliable instruments with good psychometric characteristics, for pain evaluation, discriminating between nociceptive and neuropathic pain. Our findings were similar to those observed in the original study. Furthermore, we have reported the test-retest reliability for both questionnaires, not addressed in original validation studies.
Collapse
Affiliation(s)
- Alberto Migliore
- 1Rheumatology Unit, San Pietro Fatebenefratelli Hospital, Rome, Italy
| | | | - Antimo Moretti
- 2Department of Medical and Surgical Specialties and Dentistry, University of Campania “Luigi Vanvitelli”, Naples, Italy
| | - Alessio Pietrella
- 3Neurological Section, San Pietro Fatebenefratelli Hospital, Rome, Italy
| | - Marco Peresson
- 3Neurological Section, San Pietro Fatebenefratelli Hospital, Rome, Italy
| | - Fabiola Atzeni
- 4Rheumatology Unit, University of Messina, Messina, Italy
| | | | - Laura Bazzichi
- 6Rheumatology Unit, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Sara Liguori
- 2Department of Medical and Surgical Specialties and Dentistry, University of Campania “Luigi Vanvitelli”, Naples, Italy
| | - Giovanni Iolascon
- 2Department of Medical and Surgical Specialties and Dentistry, University of Campania “Luigi Vanvitelli”, Naples, Italy
| |
Collapse
|
29
|
Liguori S, Moretti A, Palomba A, Paoletta M, Gimigliano F, De Micco R, Siciliano M, Tessitore A, Iolascon G. Non-motor impairments affect walking kinematics in Parkinson disease patients: A cross-sectional study. NeuroRehabilitation 2021; 49:481-489. [PMID: 34420985 PMCID: PMC8673525 DOI: 10.3233/nre-210146] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Accepted: 07/27/2021] [Indexed: 02/05/2023]
Abstract
BACKGROUND In patients with Parkinson disease (PD), severe postural and gait impairments are rarely observed in early stage of disease and non-motor symptoms (NMS) are often overlooked. OBJECTIVE This observational study aimed to characterize the impact of non-motor impairments on walking kinematics in early stages PD patients, and to assess the differences of gait parameters and NMS between PD patients with and without mild cognitive impairment (MCI). METHODS Twenty-six patients with Modified Hoehn and Yahr Scale score≤2 were evaluated for NMS using Kings Parkinson's Pain Scale, Parkinson Fatigue Severity scale, Parkinson Anxiety Scale, Beck Depression Inventory and Epworth Sleepiness Scale, kinematic parameters through an inertial sensor and cognitive performance by a comprehensive neuropsychological battery. RESULTS Fatigue had a moderate negative correlation with step cadence, and a moderate to strong positive correlation with gait duration, Timed Up and Go (TUG) and TUG Dual Task (p < 0.01). Pain showed positive moderate correlation with gait duration (p < 0.01). Twelve patients resulted affected by MCI and reported significantly worse scores in gait duration, pain and fatigue (p < 0.05). According to cognitive z scores, PD-MCI group showed a moderate negative correlation between visuospatial abilities and fatigue (p < 0.05). CONCLUSIONS NMS significantly affect walking kinematics whereas a limited role of cognitive status on motor performance occur in the early PD stages.
Collapse
Affiliation(s)
- Sara Liguori
- Department of Medical and Surgical Specialties and Dentistry, University of Campania “Luigi Vanvitelli”, Naples, Italy
| | - Antimo Moretti
- Department of Medical and Surgical Specialties and Dentistry, University of Campania “Luigi Vanvitelli”, Naples, Italy
| | - Angela Palomba
- Department of Medical and Surgical Specialties and Dentistry, University of Campania “Luigi Vanvitelli”, Naples, Italy
| | - Marco Paoletta
- Department of Medical and Surgical Specialties and Dentistry, University of Campania “Luigi Vanvitelli”, Naples, Italy
| | - Francesca Gimigliano
- Department of Mental and Physical Health and Preventive Medicine, University of Campania “Luigi Vanvitelli”, Naples, Italy
| | - Rosa De Micco
- Department of Advanced Medical and Surgical Sciences, University of Campania “Luigi Vanvitelli”, Naples, Italy
| | - Mattia Siciliano
- Department of Advanced Medical and Surgical Sciences, University of Campania “Luigi Vanvitelli”, Naples, Italy
- Neuropsychology Laboratory, Department of Psychology, University of Campania “Luigi Vanvitelli”, Caserta, Italy
| | - Alessandro Tessitore
- Department of Advanced Medical and Surgical Sciences, University of Campania “Luigi Vanvitelli”, Naples, Italy
| | - Giovanni Iolascon
- Department of Medical and Surgical Specialties and Dentistry, University of Campania “Luigi Vanvitelli”, Naples, Italy
| |
Collapse
|
30
|
Toro G, Moretti A, Ambrosio D, Pezzella R, De Cicco A, Landi G, Tammaro N, Florio P, Cecere AB, Braile A, Medici A, Siano A, Di Maggio B, Calabrò G, Gagliardo N, Di Fino C, Bruno G, Pellegrino A, Negri G, Monaco V, Gison M, Toro A, Schiavone Panni A, Tarantino U, Iolascon G. Fractures around Trochanteric Nails: The "Vergilius Classification System". Adv Orthop 2021; 2021:7532583. [PMID: 33520318 PMCID: PMC7817309 DOI: 10.1155/2021/7532583] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Accepted: 12/29/2020] [Indexed: 02/08/2023] Open
Abstract
INTRODUCTION The fractures that occurred around trochanteric nails (perinail fractures, PNFs) are becoming a huge challenge for the orthopaedic surgeon. Although presenting some specific critical issues (i.e., patients' outcomes and treatment strategies), these fractures are commonly described within peri-implant ones and their treatment was based on periprosthetic fracture recommendations. The knowledge gap about PNFs leads us to convene a research group with the aim to propose a specific classification system to guide the orthopaedic surgeon in the management of these fractures. MATERIALS AND METHODS A steering committee, identified by two Italian associations of orthopaedic surgeons, conducted a comprehensive literature review on PNFs to identify the unmet needs about this topic. Subsequently, a panel of experts was involved in a consensus meeting proposing a specific classification system and formulated treatment statements for PNFs. Results and Discussion. The research group considered four PNF main characteristics for the classification proposal: (1) fracture localization, (2) fracture morphology, (3) fracture fragmentation, and (3) healing status of the previous fracture. An alphanumeric code was included to identify each characteristic, allowing to describe up to 54 categories of PNFs, using a 3- to 4-digit code. The proposal of the consensus-based classification reporting the most relevant aspects for PNF treatment might be a useful tool to guide the orthopaedic surgeon in the appropriate management of these fractures.
Collapse
Affiliation(s)
- Giuseppe Toro
- 1Department of Medical and Surgical Specialties and Dentistry, University of Campania “Luigi Vanvitelli”, Naples, Italy
- 2Department of Clinical Sciences and Translational Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Antimo Moretti
- 1Department of Medical and Surgical Specialties and Dentistry, University of Campania “Luigi Vanvitelli”, Naples, Italy
| | - Daniele Ambrosio
- 3Unit of Orthopaedics and Traumatology, Evangelical Hospital Betania, Naples, Italy
| | - Raffaele Pezzella
- 4Department of Life Health & Environmental Sciences, University of L'Aquila, Unit of Orthopaedics and Traumatology, L'Aquila, Italy
| | - Annalisa De Cicco
- 1Department of Medical and Surgical Specialties and Dentistry, University of Campania “Luigi Vanvitelli”, Naples, Italy
| | - Giovanni Landi
- 1Department of Medical and Surgical Specialties and Dentistry, University of Campania “Luigi Vanvitelli”, Naples, Italy
| | - Nicola Tammaro
- 1Department of Medical and Surgical Specialties and Dentistry, University of Campania “Luigi Vanvitelli”, Naples, Italy
| | - Pasquale Florio
- 3Unit of Orthopaedics and Traumatology, Evangelical Hospital Betania, Naples, Italy
| | - Antonio Benedetto Cecere
- 1Department of Medical and Surgical Specialties and Dentistry, University of Campania “Luigi Vanvitelli”, Naples, Italy
| | - Adriano Braile
- 1Department of Medical and Surgical Specialties and Dentistry, University of Campania “Luigi Vanvitelli”, Naples, Italy
| | - Antonio Medici
- 5Unit of Orthopaedics and Traumatology, AORN S. Giuseppe Moscati, Avellino, Italy
| | - Antonio Siano
- 6Unit of Orthopaedics and Traumatology, Santa Maria Della Speranza Hospital, Battipaglia, Italy
| | - Bruno Di Maggio
- 7Unit of Orthopaedics and Traumatology, “Ave Gratia Plena” Civil Hospital, Piedimonte Matese, Italy
| | - Giampiero Calabrò
- 8Unit of Orthopaedics and Traumatology, San Francesco D'Assisi Hospital, Oliveto Citra, Italy
| | - Nicola Gagliardo
- 9Unit of Orthopaedics and Traumatology, San Giuliano Hospital, Giugliano, Italy
| | - Ciro Di Fino
- 10Unit of Orthopaedics and Traumatology, AOR San Carlo, Potenza, Italy
| | - Gaetano Bruno
- 11Unit of Orthopaedics and Traumatology, AORN Sant'Anna e San Sebastiano, Caserta, Italy
| | - Achille Pellegrino
- 12Unit of Orthopaedics and Traumatology, San Giuseppe Moscati Hospital, Aversa, Italy
| | - Giacomo Negri
- 3Unit of Orthopaedics and Traumatology, Evangelical Hospital Betania, Naples, Italy
| | - Vincenzo Monaco
- 13Unit of Orthopaedics and Traumatology, Santa Maria Incoronata Dell'Olmo Hospital, Cava de' Tirreni, Italy
| | - Michele Gison
- 14Unit of Orthopaedics and Traumatology, Villa Malta Hospital, Sarno, Italy
| | - Antonio Toro
- 14Unit of Orthopaedics and Traumatology, Villa Malta Hospital, Sarno, Italy
| | - Alfredo Schiavone Panni
- 1Department of Medical and Surgical Specialties and Dentistry, University of Campania “Luigi Vanvitelli”, Naples, Italy
| | - Umberto Tarantino
- 2Department of Clinical Sciences and Translational Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Giovanni Iolascon
- 1Department of Medical and Surgical Specialties and Dentistry, University of Campania “Luigi Vanvitelli”, Naples, Italy
| |
Collapse
|
31
|
Gimigliano F, Liguori S, Moretti A, Toro G, Rauch A, Negrini S, Curci C, Patrini M, Peschi L, Pournajaf S, Sgarbanti M, Iolascon G. Systematic review of clinical practice guidelines for adults with fractures: identification of best evidence for rehabilitation to develop the WHO's Package of Interventions for Rehabilitation. J Orthop Traumatol 2020; 21:20. [PMID: 33188610 PMCID: PMC7666651 DOI: 10.1186/s10195-020-00560-w] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Accepted: 11/01/2020] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND The identification of existing rehabilitation interventions and related evidence represents a crucial step along the development of the World Health Organization's (WHO) Package of Interventions for Rehabilitation (PIR). The methods for such identification have been developed by the WHO Rehabilitation Programme and Cochrane Rehabilitation under the guidance of the WHO's Guideline Review Committee secretariat. The aim of this paper is to report on the results of the systematic search for clinical practice guidelines (CPGs) relevant to the rehabilitation of adults with fractures and to present the current state of evidence available from the identified CPGs. METHODS This paper is part of the Best Evidence for Rehabilitation (be4rehab) series, developed according to the methodology presented in the World Health Organization's (WHO) Package of Interventions for Rehabilitation (PIR) introductory paper. It is a systematic review of existing CPGs on fractures in adult population published from 2009 to 2019. RESULTS We identified 23 relevant CPGs after title and abstract screening. According to inclusion/exclusion criteria, we selected 13 CPGs. After checking for quality, publication time, multiprofessionality, and comprehensiveness, we finally included five CPGs dealing with rehabilitative management of fractures in adult population, two CPGs addressing treatment of distal radius fracture and three the treatment of femoral/hip fracture. CONCLUSION The selected CPGs on management of distal radius and femoral/hip fracture include few recommendations regarding rehabilitation, with overall low to very low quality of evidence and weak/conditional strength of recommendation. Moreover, several gaps in specific rehabilitative topics occur. Further high-quality trials are required to upgrade the quality of the available evidence. LEVEL OF EVIDENCE Level 1.
Collapse
Affiliation(s)
- Francesca Gimigliano
- Department of Mental and Physical Health and Preventive Medicine, University of Campania "Luigi Vanvitelli", Largo Madonna delle Grazie n. 1, 80138, Naples, Italy
| | - Sara Liguori
- Department of Medical and Surgical Specialties and Dentistry, University of Campania "Luigi Vanvitelli", Via De Crecchio n.4, 80138, Naples, Italy.
| | - Antimo Moretti
- Department of Medical and Surgical Specialties and Dentistry, University of Campania "Luigi Vanvitelli", Via De Crecchio n.4, 80138, Naples, Italy
| | - Giuseppe Toro
- Department of Medical and Surgical Specialties and Dentistry, University of Campania "Luigi Vanvitelli", Via De Crecchio n.4, 80138, Naples, Italy
| | - Alexandra Rauch
- Rehabilitation Programme World Health Organization, Avenue Appia 20,, 1211, Geneva 27, Switzerland
| | - Stefano Negrini
- IRCCS Istituto Ortopedico Galeazzi, Milan, Italy
- Department of Biomedical, Surgical, and Dental Sciences, University La Statale, Milan, Italy
| | | | | | | | | | | | - Giovanni Iolascon
- Department of Medical and Surgical Specialties and Dentistry, University of Campania "Luigi Vanvitelli", Via De Crecchio n.4, 80138, Naples, Italy
| |
Collapse
|
32
|
Abstract
Management of Osteoarthritis (OA) still is a challenge for clinicians. Taking into account a multidisciplinary approach including pharmacological and non-pharmacological treatments, intra-articular (IA) injection could be considered as an effective local therapy. Areas covered This review provides a new perspective of IA treatment going beyond current available IA agents. We describe novel biological targets for developing new IA agents and innovative modalities of delivery systems. Additional topics include predictors of response for a better choice of IA agents for each patient, diagnostic and prognostic role of biomarkers, accuracy of IA injection, and cost-effectiveness of IA injection. Expert opinion IA treatments seem to be very promising for the management of OA. Identifying clinical and biochemical predictive factors could drive clinician to the appropriate therapeutic approach. To date, there is a gap regarding the benefit of IA treatments in the 'real practice' once they have been adopted. However, considering these promising effects of IA approach, several open questions remain not clarified.
Collapse
Affiliation(s)
| | - Marco Paoletta
- Department of Medical and Surgical Specialties and Dentistry, University of Campania "Luigi Vanvitelli" , Naples, Italy
| | - Antimo Moretti
- Department of Medical and Surgical Specialties and Dentistry, University of Campania "Luigi Vanvitelli" , Naples, Italy
| | - Sara Liguori
- Department of Medical and Surgical Specialties and Dentistry, University of Campania "Luigi Vanvitelli" , Naples, Italy
| | - Giovanni Iolascon
- Department of Medical and Surgical Specialties and Dentistry, University of Campania "Luigi Vanvitelli" , Naples, Italy
| |
Collapse
|
33
|
Moretti A, Menna F, Aulicino M, Paoletta M, Liguori S, Iolascon G. Characterization of Home Working Population during COVID-19 Emergency: A Cross-Sectional Analysis. Int J Environ Res Public Health 2020; 17:ijerph17176284. [PMID: 32872321 PMCID: PMC7503869 DOI: 10.3390/ijerph17176284] [Citation(s) in RCA: 89] [Impact Index Per Article: 22.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Revised: 08/22/2020] [Accepted: 08/23/2020] [Indexed: 02/05/2023]
Abstract
Evidence about the characterization of home workers in terms of both work-related outcomes and health issues is lacking. The purpose of this cross-sectional study was to examine the impact of home working on perceived job productivity and satisfaction, work-related stress, and musculoskeletal (MSK) issues. We included 51 mobile workers, collecting data about demographic characteristics, working experience, job productivity, and stress. Job satisfaction was assessed through the Utrecht Work Engagement Scale (UWES), while MSK pain was investigated by the Brief Pain Inventory (BPI) and Fear Avoidance Beliefs Questionnaire (FABQ). Moreover, a home workplace analysis had to be carried out according to current Italian regulations. Participants declared that they were less productive (39.2%) but less stressed (39.2%) and equally satisfied (51%) compared to the time of office working. Regarding MSK disorders, low back pain (LBP) was referred by 41.2% of home workers and neck pain by 23.5% of them. Neck pain worsened in 50% of home workers, while LBP did not exacerbate in 47.6% of cases. Home workers with MSK pain reported a lower job satisfaction. Depending on our data, the home environment seems to be not adequate in the mobile worker population, with an increased risk for mental health and MSK problems, particularly affecting the spine. Addressing these issues can significantly reduce risks for health, thus, improving job productivity and satisfaction and reducing cost.
Collapse
|
34
|
Paoletta M, Moretti A, Liguori S, Bertone M, Toro G, Iolascon G. Transient osteoporosis of the hip and subclinical hypothyroidism: an unusual dangerous duet? Case report and pathogenetic hypothesis. BMC Musculoskelet Disord 2020; 21:543. [PMID: 32791961 PMCID: PMC7427076 DOI: 10.1186/s12891-020-03574-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Accepted: 08/06/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Transient osteoporosis of the hip (TOH) is a rare and temporary clinical condition characterised by bone marrow edema (BME), severe pain, and functional limitation. It commonly occurs in middle-aged men or in women in the last trimester of pregnancy. TOH usually resolves with conservative therapy but may predispose to hip fracture or progression to avascular necrosis (AVN). Etiology is still unclear, although several pathophysiological mechanisms underpinning this condition has been proposed. We describe the management of an unusual case of TOH occurred in a patient with subclinical hypothyroidism. CASE PRESENTATION A clinical case of a 46-year-old man with severe pain in the left anterior thigh is presented. After a comprehensive clinical and radiological approach, a TOH was diagnosed. Moreover, biochemical assessment suggested the presence of subclinical hypothyroidism. After 3 months of treatment with clodronate, physical therapy and hormone replacement therapy (HRT) a significant improvement of clinical and radiological outcomes was observed. CONCLUSION Several pathological conditions have been related to development of TOH. In our case, we suggested for the first time a role of subclinical hypothyroidism as novel contributory factor for the onset of this condition, providing pathophysiological mechanisms and a scientific rationale for pharmacological treatment.
Collapse
Affiliation(s)
- Marco Paoletta
- Department of Medical and Surgical Specialties and Dentistry, University of Campania "Luigi Vanvitelli", Via De Crecchio 4, 80138, Naples, Italy
| | - Antimo Moretti
- Department of Medical and Surgical Specialties and Dentistry, University of Campania "Luigi Vanvitelli", Via De Crecchio 4, 80138, Naples, Italy.
| | - Sara Liguori
- Department of Medical and Surgical Specialties and Dentistry, University of Campania "Luigi Vanvitelli", Via De Crecchio 4, 80138, Naples, Italy
| | - Matteo Bertone
- Department of Medical and Surgical Specialties and Dentistry, University of Campania "Luigi Vanvitelli", Via De Crecchio 4, 80138, Naples, Italy
| | - Giuseppe Toro
- Department of Medical and Surgical Specialties and Dentistry, University of Campania "Luigi Vanvitelli", Via De Crecchio 4, 80138, Naples, Italy
| | - Giovanni Iolascon
- Department of Medical and Surgical Specialties and Dentistry, University of Campania "Luigi Vanvitelli", Via De Crecchio 4, 80138, Naples, Italy
| |
Collapse
|
35
|
Moretti A. Are TNF-α blockers effective and safe for Kawasaki disease in children? A Cochrane Review summary with commentary. Int J Rheum Dis 2020; 23:1252-1254. [PMID: 32761848 DOI: 10.1111/1756-185x.13884] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2020] [Revised: 05/24/2020] [Accepted: 05/25/2020] [Indexed: 02/05/2023]
Affiliation(s)
- Antimo Moretti
- Department of Medical and Surgical Specialties and Dentistry, University of Campania "Luigi Vanvitelli", Naples, Italy
| |
Collapse
|
36
|
Moretti A, Paoletta M, Liguori S, Bertone M, Toro G, Iolascon G. Choline: An Essential Nutrient for Skeletal Muscle. Nutrients 2020; 12:nu12072144. [PMID: 32708497 PMCID: PMC7400816 DOI: 10.3390/nu12072144] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Revised: 07/16/2020] [Accepted: 07/17/2020] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Choline is an essential micronutrient with a pivotal role in several metabolic pathways contributing to liver, neurological, and hematological homeostasis. Although choline is commonly administered to improve physical performance, its effects on muscle are still unclear. The aim of this scoping review is to analyze the role of choline on skeletal muscle in terms of biological effects and clinical implications. METHODS A technical expert panel (TEP) of 6 medical specialists with expertise in muscle physiology and skeletal muscle disorders performed the review following the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews) model. The TEP planned a research on PubMed selecting "choline" as MeSH (Medical Subject Headings) term adding to PubMed Search Builder the terms "skeletal muscle" and "muscle striated". TEP considered for eligibility articles published in the last 30 years, including original researches, particularly in vitro studies, and animal and clinical studies in the English language. RESULTS From the 1239 studies identified, TEP included 14 studies, 3 in vitro, 9 animal, and 2 clinical studies. CONCLUSIONS Our scoping review elucidates and summarizes the crucial role of choline in modulating muscle fat metabolism, muscle proteins homeostasis, and the modulation of inflammation and autophagy.
Collapse
|
37
|
Iolascon G, Vitacca M, Carraro E, Chisari C, Fiore P, Messina S, Mongini T, Moretti A, Sansone VA, Toscano A, Siciliano G. Adapted physical activity and therapeutic exercise in late-onset Pompe disease (LOPD): a two-step rehabilitative approach. Neurol Sci 2020; 41:859-868. [PMID: 31811531 DOI: 10.1007/s10072-019-04178-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2019] [Accepted: 11/25/2019] [Indexed: 02/08/2023]
Abstract
Aerobic exercise, training to sustain motor ability, and respiratory rehabilitation may improve general functioning and quality of life (QoL) in neuromuscular disorders. Patients with late-onset Pompe disease (LOPD) typically show progressive muscle weakness, respiratory dysfunction and minor cardiac involvement. Characteristics and modalities of motor and respiratory rehabilitation in LOPD are not well defined and specific guidelines are lacking. Therefore, we evaluated the role of physical activity, therapeutic exercise, and pulmonary rehabilitation programs in order to promote an appropriate management of motor and respiratory dysfunctions and improve QoL in patients with LOPD. We propose two operational protocols: one for an adapted physical activity (APA) plan and the other for an individual rehabilitation plan, particularly focused on therapeutic exercise (TE) and respiratory rehabilitation.
Collapse
Affiliation(s)
- Giovanni Iolascon
- Department of Medical and Surgical Specialties and Dentistry, University of Campania "Luigi Vanvitelli", Via De Crecchio 4, 80138, Naples, Italy.
| | - Michele Vitacca
- FERS Respiratory Rehabilitation Unit, ICS S. Maugeri IRCCS, Lumezzane, BS, Italy
| | - Elena Carraro
- NeuroMuscular Omnicentre, Fondazione Serena Onlus, Neurorehabilitation Unit, University of Milan, Milan, Italy
| | - Carmelo Chisari
- Unit of Neurorehabilitation, Department of Medical Specialties, University Hospital of Pisa, Pisa, Italy
| | - Pietro Fiore
- Department of Basic Sciences, Neuroscience and Sense Organs, University of Bari "Aldo Moro", Bari, Italy
| | - Sonia Messina
- Neurology and Neuromuscular Unit, University of Messina, Messina, Italy
| | - Tiziana Mongini
- Neuromuscular Unit, Department of Neurosciences, University of Turin, Turin, Italy
| | - Antimo Moretti
- Department of Medical and Surgical Specialties and Dentistry, University of Campania "Luigi Vanvitelli", Via De Crecchio 4, 80138, Naples, Italy
| | - Valeria A Sansone
- NeuroMuscular Omnicentre, Fondazione Serena Onlus, Neurorehabilitation Unit, University of Milan, Milan, Italy
| | - Antonio Toscano
- Neurology and Neuromuscular Unit, University of Messina, Messina, Italy
| | - Gabriele Siciliano
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | | |
Collapse
|
38
|
Moretti A, Gimigliano F, Arienti C, Pollet J, Kiekens C, Negrini S. Published Erratum: Duplicate publication: The Cochrane Rehabilitation eBook: a knowledge translation tool to transfer evidence to different rehabilitation audiences. Eur J Phys Rehabil Med 2020; 56:255. [PMID: 32415057 DOI: 10.23736/s1973-9087.20.06250-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
This article was accidentally published in Volume 54 issue 5 as well as Volume 54 issue 4 of publishing year 2018 with different DOIs and different page numbers. The correct and citable version of the article remains Antimo MORETTI, Francesca GIMIGLIANO, Chiara ARIENTI, Joel POLLET, Carlotte KIEKENS, Stefano NEGRINI. The Cochrane Rehabilitation eBook: a knowledge translation tool to transfer evidence to different rehabilitation audiences. Eur J Phys Rehabil Med 2018 August;54(4):622-3. DOI: 10.23736/S1973-9087.18.05373-X
Collapse
Affiliation(s)
- Antimo Moretti
- Department of Medical and Surgical Specialties and Dentistry, Luigi Vanvitelli University of Campania, Naples, Italy
| | - Francesca Gimigliano
- Department of Mental and Physical Health and Preventive Medicine, Luigi Vanvitelli University of Campania, Naples, Italy
| | | | - Joel Pollet
- Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Carlotte Kiekens
- KU Leuven, PRM, Leuven, Belgium
- University Hospitals Leuven, Physical and Rehabilitation Medicine, Leuven, Belgium, The originally published version of this article is available online at https://www.doi.org/10.23736/S1973-9087.18.05373-X
| | - Stefano Negrini
- IRCCS Don Gnocchi Foundation, Milan, Italy
- Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| |
Collapse
|
39
|
Moretti A. Is botulinum toxin effective and safe for motor and phonic tics in patients affected by Tourette syndrome? A Cochrane Review summary with commentary. Dev Med Child Neurol 2020; 62:274-276. [PMID: 31957864 DOI: 10.1111/dmcn.14472] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2020] [Accepted: 01/03/2020] [Indexed: 02/05/2023]
Affiliation(s)
- Antimo Moretti
- Department of Medical and Surgical Specialties and Dentistry, University of Campania "Luigi Vanvitelli", Naples, Italy
| |
Collapse
|
40
|
Nastri L, Moretti A, Migliaccio S, Paoletta M, Annunziata M, Liguori S, Toro G, Bianco M, Cecoro G, Guida L, Iolascon G. Do Dietary Supplements and Nutraceuticals Have Effects on Dental Implant Osseointegration? A Scoping Review. Nutrients 2020; 12:nu12010268. [PMID: 31968626 PMCID: PMC7019951 DOI: 10.3390/nu12010268] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2019] [Revised: 01/17/2020] [Accepted: 01/18/2020] [Indexed: 02/07/2023] Open
Abstract
Several factors affect dental implant osseointegration, including surgical issues, bone quality and quantity, and host-related factors, such as patients' nutritional status. Many micronutrients might play a key role in dental implant osseointegration by influencing some alveolar bone parameters, such as healing of the alveolus after tooth extraction. This scoping review aims to summarize the role of dietary supplements in optimizing osseointegration after implant insertion surgery. A technical expert panel (TEP) of 11 medical specialists with expertise in oral surgery, bone metabolism, nutrition, and orthopedic surgery performed the review following the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews) model. The TEP identified micronutrients from the "European Union (EU) Register of nutrition and health claims made on foods" that have a relationship with bone and tooth health, and planned a PubMed search, selecting micronutrients previously identified as MeSH (Medical Subject Headings) terms and adding to each of them the words "dental implants" and "osseointegration". The TEP identified 19 studies concerning vitamin D, magnesium, resveratrol, vitamin C, a mixture of calcium, magnesium, zinc, and vitamin D, and synthetic bone mineral. However, several micronutrients are non-authorized by the "EU Register on nutrition and health claims" for improving bone and/or tooth health. Our scoping review suggests a limited role of nutraceuticals in promoting osseointegration of dental implants, although, in some cases, such as for vitamin D deficiency, there is a clear link among their deficit, reduced osseointegration, and early implant failure, thus requiring an adequate supplementation.
Collapse
Affiliation(s)
- Livia Nastri
- Department of Medical and Surgical Specialties and Dentistry, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy; (L.N.); (M.P.); (M.A.); (S.L.); (G.T.); (M.B.); (G.C.); (L.G.); (G.I.)
| | - Antimo Moretti
- Department of Medical and Surgical Specialties and Dentistry, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy; (L.N.); (M.P.); (M.A.); (S.L.); (G.T.); (M.B.); (G.C.); (L.G.); (G.I.)
- Correspondence: ; Tel.: +39-08-1566-5537
| | - Silvia Migliaccio
- Department of Movement, Human and Health Sciences, Unit Endocrinology, University Foro Italico, 00135 Rome, Italy;
| | - Marco Paoletta
- Department of Medical and Surgical Specialties and Dentistry, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy; (L.N.); (M.P.); (M.A.); (S.L.); (G.T.); (M.B.); (G.C.); (L.G.); (G.I.)
| | - Marco Annunziata
- Department of Medical and Surgical Specialties and Dentistry, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy; (L.N.); (M.P.); (M.A.); (S.L.); (G.T.); (M.B.); (G.C.); (L.G.); (G.I.)
| | - Sara Liguori
- Department of Medical and Surgical Specialties and Dentistry, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy; (L.N.); (M.P.); (M.A.); (S.L.); (G.T.); (M.B.); (G.C.); (L.G.); (G.I.)
| | - Giuseppe Toro
- Department of Medical and Surgical Specialties and Dentistry, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy; (L.N.); (M.P.); (M.A.); (S.L.); (G.T.); (M.B.); (G.C.); (L.G.); (G.I.)
| | - Massimiliano Bianco
- Department of Medical and Surgical Specialties and Dentistry, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy; (L.N.); (M.P.); (M.A.); (S.L.); (G.T.); (M.B.); (G.C.); (L.G.); (G.I.)
| | - Gennaro Cecoro
- Department of Medical and Surgical Specialties and Dentistry, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy; (L.N.); (M.P.); (M.A.); (S.L.); (G.T.); (M.B.); (G.C.); (L.G.); (G.I.)
| | - Luigi Guida
- Department of Medical and Surgical Specialties and Dentistry, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy; (L.N.); (M.P.); (M.A.); (S.L.); (G.T.); (M.B.); (G.C.); (L.G.); (G.I.)
| | - Giovanni Iolascon
- Department of Medical and Surgical Specialties and Dentistry, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy; (L.N.); (M.P.); (M.A.); (S.L.); (G.T.); (M.B.); (G.C.); (L.G.); (G.I.)
| |
Collapse
|
41
|
Iolascon G, Moretti A, Toro G, Gimigliano F, Liguori S, Paoletta M. Pharmacological Therapy of Osteoporosis: What's New? Clin Interv Aging 2020; 15:485-491. [PMID: 32273690 PMCID: PMC7105363 DOI: 10.2147/cia.s242038] [Citation(s) in RCA: 46] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2019] [Accepted: 02/07/2020] [Indexed: 02/05/2023] Open
Abstract
Osteoporosis and fragility fractures are relevant health issues because of their impact in terms of morbidity, mortality, and socioeconomic burden. Despite this alarming scenario, both underdiagnosis and undertreatment are common features of osteoporotic patients, particularly those who have already sustained a fragility fracture. Pharmacotherapy of osteoporosis is the main treatment option for these patients because of strong evidence about the efficacy of available drugs targeting bone metabolism. However, several issues can interfere with the effectiveness of anti-osteoporotic drugs in clinical practice, such as lack of awareness of both healthcare providers and patients, poor adherence to therapy, and safety in long-term treatment. Therefore, new therapeutic strategies have been proposed to overcome these problems, such as sequential therapy or emerging molecules mainly targeting the stimulation of bone formation. In particular, abaloparatide has been demonstrated to reduce major nonvertebral fracture risk compared with both placebo and teriparatide, although the European Medicines Agency (EMA) refused the marketing authorization because the benefits of this drug did not outweigh its risks. On the other side, EMA has recently approved romosozumab, a monoclonal antibody directed against sclerostin and the only available therapeutic option targeting Wnt signaling, as both bone-forming and antiresorptive intervention to treat osteoporosis and fragility fractures.
Collapse
Affiliation(s)
- Giovanni Iolascon
- Department of Medical and Surgical Specialties and Dentistry, University of Campania “Luigi Vanvitelli”, Naples, Italy
| | - Antimo Moretti
- Department of Medical and Surgical Specialties and Dentistry, University of Campania “Luigi Vanvitelli”, Naples, Italy
- Correspondence: Antimo Moretti Department of Medical and Surgical Specialties and Dentistry, University of Campania “Luigi Vanvitelli”, Naples, Italy Email
| | - Giuseppe Toro
- Department of Medical and Surgical Specialties and Dentistry, University of Campania “Luigi Vanvitelli”, Naples, Italy
| | - Francesca Gimigliano
- Department of Physical and Mental Health and Preventive Medicine, University of Campania “Luigi Vanvitelli”, Naples, Italy
| | - Sara Liguori
- Department of Medical and Surgical Specialties and Dentistry, University of Campania “Luigi Vanvitelli”, Naples, Italy
| | - Marco Paoletta
- Department of Medical and Surgical Specialties and Dentistry, University of Campania “Luigi Vanvitelli”, Naples, Italy
| |
Collapse
|
42
|
Iolascon G, de Sire A, Calafiore D, Benedetti MG, Cisari C, Letizia Mauro G, Migliaccio S, Nuti R, Resmini G, Gonnelli S, Moretti A. Multifactorial Assessment of Risk of Falling in 753 Post-Menopausal Women: A Multicenter Cross-Sectional Study by the Italian Group for the Study of Metabolic Bone Diseases. Clin Interv Aging 2020; 15:1077-1084. [PMID: 32753859 PMCID: PMC7354000 DOI: 10.2147/cia.s257304] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Accepted: 06/05/2020] [Indexed: 02/05/2023] Open
Abstract
OBJECTIVE To assess physical performance, number of falls, previous fragility fractures, and ongoing pharmacological therapy in a cohort of post-menopausal women, according to their risk of falling. METHODS In this multicenter cross-sectional study, we recruited in a 3-year period (May 2016 to April 2019), women aged >60 years referred to seven Osteoporosis and Bone Metabolism Outpatient Services of the Italian Group for the Study of Metabolic Bone Diseases. The study population was divided into three groups according to the risk of falling, assessed through the Elderly Fall Screening Test (EFST): low risk (EFST score=0-1); moderate risk (EFST=2-3); high risk (EFST=4-5). Outcome measures were: 4-meter gait speed (4MGS); unipedal stance time (UST); number of falls in the previous year; previous fragility fractures; ongoing pharmacological therapy. RESULTS We analyzed 753 women (mean aged 70.1±9.2 years): 378 (50.2%) at low risk of falling, 247 (32.8%) at moderate risk, and 128 (17.0%) at high risk. 4MGS and UST resulted as pathological in the 93.9% and 99.2%, respectively, of women at high risk. There were significant differences among groups for both outcomes (p<0.001). There was also a significant difference among groups (p<0.001) in terms of previous falls and fragility fractures. Lastly, there were significant differences (p<0.05) among groups in using antihypertensive drugs, antiplatelet agents, anticoagulants, antidepressants, anti-osteoporotic drugs, and vitamin D, and/or calcium supplementation. CONCLUSION Physical performance, prevalence of falls and fragility fractures, and an assessment of pharmacological therapy should be investigated in post-menopausal women because of their significant correlation with risk of falling.
Collapse
Affiliation(s)
- Giovanni Iolascon
- Department of Medical and Surgical Specialties and Dentistry, University of Campania “Luigi Vanvitelli”, Naples, Italy
| | - Alessandro de Sire
- Department of Medical and Surgical Specialties and Dentistry, University of Campania “Luigi Vanvitelli”, Naples, Italy
- Physical and Rehabilitative Medicine, Department of Health Sciences, University of Eastern Piedmont “A. Avogadro”, Novara, Italy
- Rehabilitation Unit, “Mons L. Novarese” Hospital, Vercelli, Moncrivello, Italy
- Correspondence: Alessandro de Sire Physical and Rehabilitative Medicine, Department of Health Sciences, University of Eastern Piedmont “A. Avogadro”, Viale Piazza D’Armi 1, Novara28100, ItalyTel +3903213734800 Email
| | - Dario Calafiore
- Department of Medical and Surgical Specialties and Dentistry, University of Campania “Luigi Vanvitelli”, Naples, Italy
- Section of Neuromotor Rehabilitation, Department of Neuroscience, ASST Carlo Poma, Mantova, Italy
| | - Maria Grazia Benedetti
- Physical Medicine and Rehabilitation Unit, IRCCS-Istituto Ortopedico Rizzoli, Bologna, Italy
| | - Carlo Cisari
- Physical and Rehabilitative Medicine, Department of Health Sciences, University of Eastern Piedmont “A. Avogadro”, Novara, Italy
- Physical Medicine and Rehabilitation Unit, University Hospital “Maggiore della Carità”, Novara, Italy
| | - Giulia Letizia Mauro
- Department of Surgical and Oncology Sciences, University of Palermo, Palermo, Italy
| | - Silvia Migliaccio
- Department of Movement, Human and Health Sciences, Section of Health Sciences, University of Rome, Foro Italico, Rome, Italy
| | - Ranuccio Nuti
- Department of Medicine, Surgery and Neuroscience, University of Siena, Siena, Italy
| | - Giuseppina Resmini
- Section of Orthopaedics and Traumatology, Treviglio-Caravaggio Hospital, Treviglio, Bergamo, Italy
| | - Stefano Gonnelli
- Department of Medicine, Surgery and Neuroscience, University of Siena, Siena, Italy
| | - Antimo Moretti
- Department of Medical and Surgical Specialties and Dentistry, University of Campania “Luigi Vanvitelli”, Naples, Italy
| |
Collapse
|
43
|
Abstract
Hip fractures are severe conditions with a high morbidity and mortality, especially when the diagnosis is delayed, and if formulated over 30 days after the injury, is termed a 'neglected femoral neck fracture' (NFNF).Cerebral palsy (CP) is probably one of the major risk factors for NFNF in Western countries, mainly because of both cognitive and motor impairments. However, considering the high prevalence of fractures in these patients, the incidence of NFNF in this population is probably underestimated, and this condition might result in persistent hip or abdominal pain.Several techniques are available for the treatment of NFNF (i.e. muscle pedicle bone graft, fixation with fibular graft, valgisation osteotomy), but most of them could affect motor function.Motor function must be preserved for as long as possible, in order to enhance the quality of life of CP patients.After discussing published NFNF cases in CP patients and available treatment options, a practical approach is proposed to facilitate the orthopaedic surgeon to both early identify and appropriately manage these challenging fractures. Cite this article: EFORT Open Rev 2020;5:58-64. DOI: 10.1302/2058-5241.5.190019.
Collapse
Affiliation(s)
- Giuseppe Toro
- Department of Medical and Surgical Specialties and Dentistry, University of Campania ‘Luigi Vanvitelli’, Naples, Italy
- Department of Clinical Sciences and Translational Medicine, University of Rome Tor Vergata, Rome, Italy
- Giuseppe Toro, University of Campania ‘Luigi Vanvitelli’, Department of Medical and Surgical Specialties and Dentistry, Via L. De Crecchio 4, 80138 Naples, Italy.
| | - Antimo Moretti
- Department of Medical and Surgical Specialties and Dentistry, University of Campania ‘Luigi Vanvitelli’, Naples, Italy
| | - Marco Paoletta
- Department of Medical and Surgical Specialties and Dentistry, University of Campania ‘Luigi Vanvitelli’, Naples, Italy
| | - Annalisa De Cicco
- Department of Medical and Surgical Specialties and Dentistry, University of Campania ‘Luigi Vanvitelli’, Naples, Italy
| | - Adriano Braile
- Department of Medical and Surgical Specialties and Dentistry, University of Campania ‘Luigi Vanvitelli’, Naples, Italy
| | - Alfredo Schiavone Panni
- Department of Medical and Surgical Specialties and Dentistry, University of Campania ‘Luigi Vanvitelli’, Naples, Italy
| |
Collapse
|
44
|
Abstract
Neuromuscular diseases (NMDs) are inherited or acquired conditions affecting skeletal muscles, motor nerves, or neuromuscular junctions. Most of them are characterized by a progressive damage of muscle fibers with reduced muscle strength, disability, and poor health-related quality of life of affected patients. In this scenario, skeletal health is usually compromised as a consequence of modified bone-muscle cross-talk including biomechanical and bio-humoral issues, resulting in increased risk of bone fragility and fractures. In addition, NMD patients frequently face nutritional issues, including malnutrition due to feeding disorders and swallowing problems that might affect bone health. Moreover, in these patients, low levels of physical activity or immobility are common and might lead to overweight or obesity that can also interfere with bone strength features. Also, vitamin D deficiency could play a critical role both in the pathogenesis and in the clinical scenario of many NMDs, suggesting that its correction could be useful in maintaining or enhancing bone health, especially in the early phases of NMDs. Last but not least, specific disease-modifying drugs, available for some NMDs, are frequently burdened with adverse effects on bone tissue. For example, glucocorticoid therapy, standard of care for many muscular dystrophies, prolongs long-term survival in treated patients; nevertheless, high dose and/or chronic use of these drugs are a common cause of secondary osteoporosis. This review addresses the current state of knowledge about the factors that play a role in determining bone alterations reported in NMDs, how these factors can modify the biological pathways underlying bone health, and which are the available interventions to manage bone involvement in patients affected by NMDs. Considering the complexity of care of these patients, an interdisciplinary and multimodal management strategy based on both pharmacological and non-pharmacological interventions is recommended, particularly targeting musculoskeletal issues that are closely related to functional independence as well as social implications.
Collapse
Affiliation(s)
- Giovanni Iolascon
- Department of Medical and Surgical Specialties and Dentistry, University of Campania “Luigi Vanvitelli”, Naples, Italy
| | | | | | | | | |
Collapse
|
45
|
Moretti A, Iolascon G. Denosumab Treatment Improves Health-Related Quality of Life in Osteoporosis: Is It Still an Attractive Topic? JBMR Plus 2019; 3:e10220. [PMID: 31667460 PMCID: PMC6808220 DOI: 10.1002/jbm4.10220] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2019] [Accepted: 05/13/2019] [Indexed: 02/05/2023] Open
Affiliation(s)
- Antimo Moretti
- Department of Medical and Surgical Specialties and DentistryUniversity of Campania “Luigi Vanvitelli”NaplesItaly
| | - Giovanni Iolascon
- Department of Medical and Surgical Specialties and DentistryUniversity of Campania “Luigi Vanvitelli”NaplesItaly
| |
Collapse
|
46
|
Sgambato D, Gimigliano F, De Musis C, Moretti A, Toro G, Ferrante E, Miranda A, De Mauro D, Romano L, Iolascon G, Romano M. Bone alterations in inflammatory bowel diseases. World J Clin Cases 2019; 7:1908-1925. [PMID: PMID: 31423424 PMCID: PMC6695530 DOI: 10.12998/wjcc.v7.i15.1908] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2019] [Revised: 06/14/2019] [Accepted: 06/27/2019] [Indexed: 02/05/2023] Open
Abstract
Inflammatory bowel diseases (IBDs) are characterized by a multifactorial partially unknown etiology that involves genetic, immunological and environmental factors. Up to 50% of IBD patients experience at least one extraintestinal manifestation; among them is the involvement of bone density which is referred to as metabolic bone disease (MBD), including osteopenia and osteoporosis. Bone alterations in IBDs population appear to have a multifactorial etiology: Decreased physical activity, inflammation-related bone resorption, multiple intestinal resections, dietary malabsorption of minerals and vitamin D deficiency, genetic factors, gut-bone immune signaling interaction, steroid treatment, microbiota and pathogenic micro-organisms interaction, and dietary malabsorption of minerals, that, all together or individually, may contribute to the alteration of bone mineral density. This review aims to summarize the prevalence and pathophysiology of metabolic bone alterations in IBD subjects outlining the main risk factors of bone fragility. We also want to underline the role of the screening and prophylaxis of bone alterations in Crohn’s disease and ulcerative colitis patients and the importance of treating appropriately MBD.
Collapse
Affiliation(s)
- Dolores Sgambato
- Departments of Precision Medicine and Polyspecialistic Internal Medicine, University of Campania ‘‘Luigi Vanvitelli’’ and University Hospital, Naples 80131, Italy
| | - Francesca Gimigliano
- Department of Physical and Mental Health, University of Campania “Luigi Vanvitelli”, Naples 80131, Italy
| | - Cristiana De Musis
- Departments of Precision Medicine and Polyspecialistic Internal Medicine, University of Campania ‘‘Luigi Vanvitelli’’ and University Hospital, Naples 80131, Italy
| | - Antimo Moretti
- Department of Medical and Surgical Specialties and Dentistry, University of Campania “Luigi Vanvitelli”, Naples 80131, Italy
| | - Giuseppe Toro
- Department of Medical and Surgical Specialties and Dentistry, University of Campania “Luigi Vanvitelli”, Naples 80131, Italy
| | - Emanuele Ferrante
- Departments of Precision Medicine and Polyspecialistic Internal Medicine, University of Campania ‘‘Luigi Vanvitelli’’ and University Hospital, Naples 80131, Italy
| | - Agnese Miranda
- Departments of Precision Medicine and Polyspecialistic Internal Medicine, University of Campania ‘‘Luigi Vanvitelli’’ and University Hospital, Naples 80131, Italy
| | - Domenico De Mauro
- Departments of Precision Medicine and Polyspecialistic Internal Medicine, University of Campania ‘‘Luigi Vanvitelli’’ and University Hospital, Naples 80131, Italy
| | - Lorenzo Romano
- Surgical Digestive Endoscopy, Department of Clinical Medicine and Surgery, Federico II University, Naples 80131, Italy
| | - Giovanni Iolascon
- Department of Medical and Surgical Specialties and Dentistry, University of Campania “Luigi Vanvitelli”, Naples 80131, Italy
| | - Marco Romano
- Departments of Precision Medicine and Polyspecialistic Internal Medicine, University of Campania ‘‘Luigi Vanvitelli’’ and University Hospital, Naples 80131, Italy
| |
Collapse
|
47
|
Abstract
INTRODUCTION Complex regional pain syndromes (CRPS) are rare painful conditions characterized by considerable variability in possible triggering factors, usually traumatic, and in the clinical scenario. The limited knowledge of the pathophysiological mechanisms has led to countless treatment attempts with multiple conservative and surgical options that act by different mechanisms of action. AREAS COVERED In this narrative review, the authors discuss key points about CRPS definitions, diagnostic criteria and pitfalls, pathophysiological hypotheses, and treatment strategies with particular reference to pharmacotherapy. The article was based on a literature search using PubMed while the available guidelines for the management of CRPS were also examined. EXPERT OPINION According to the quality of evidence, pharmacological interventions for CRPS seem to be more effective all the more so when they act on peripheral mechanisms, particularly on nociceptive pain, and when applied early in the disease, while reliable evidence about central mechanisms of chronic pain in CRPS is lacking. In our opinion, drug therapy should be preferred as early as possible, particularly in warm forms of CRPS to prevent significant functional limitation, psychological distress, and social and economic fallout.
Collapse
Affiliation(s)
- Giovanni Iolascon
- a Department of Medical and Surgical Specialties and Dentistry , University of Campania "Luigi Vanvitelli" , Naples , Italy
| | - Antimo Moretti
- a Department of Medical and Surgical Specialties and Dentistry , University of Campania "Luigi Vanvitelli" , Naples , Italy
| |
Collapse
|
48
|
Toro G, Langella F, Gison M, Toro G, Moretti A, Toro A, Iolascon G. Stentoplasty of calcaneal fractures: Surgical technique and early outcomes. Injury 2019; 50 Suppl 2:S70-S74. [PMID: 30739765 DOI: 10.1016/j.injury.2019.01.049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Calcaneus is the most common site of hindfoot fracture, frequently caused by fall from height or high energy trauma. The therapeutic strategy ranged from non-operative to ORIF (Open Reduction Internal Fixation). Indications for percutaneous fixation include soft tissue damage or relative contraindications to open surgery. Minimally invasive percutaneous calcaneoplasty should be an alternative to ORIF aiming to reach a stable reduction, early functional recovery and short hospital stay. The aim of our study was to evaluate the clinical and radiographic outcomes of calcaneus fractures treated with balloon calcaneoplasty (BCP) by using a new generation vertebral augmentation system, VBS™-Vertebral Body Stent-DePuy Synthes. A total of 10 patients treated with VBS™ system were recruited for the study. Nine fractures were caused by a fall from height and one case by traffic accident. The mean follow-up was 8.9 months (range 2.6-23.1). The fractures were categorized according to Sanders and Essex-Lopresti classifications (5: type II, 3: type III and 2: type IV; 9: "joint depression" type and 1 case "tongue" type). Radiographic measurement (Böhler's and Gissane's angles) were evaluated at both pre-operative and immediate postoperative time. The American Orthopaedic Foot and Ankle Society (AOFAS) Ankle-Hindfoot score as well as a subjective evaluation (Visual Analog Scale, VAS) were used for the clinical assessment at the last follow-up. Mean preoperative Böhler's angle was 12.3 ± 8.41° (95% CI 6.3-18.3°), whereas mean preoperative Gissane's angle was 123.66 ± 20.47° (95% CI 109.0-138.3°). At postoperative follow-up mean Böhler's angle increased to 21.51 ± 4.17° (95% CI 18.5-24.5°; p < 0.01), and mean postoperative Gissane's angle was 121.74°±6.82° (95% CI 116.8°-126.6°). Mean AOFAS at the last follow-up was 70.4 ± 17.44 (95% CI 57.9-82.8). Our study demonstrates that percutaneous calcaneoplasty using VBS™ is an effective treatment for calcaneus fracture and capable to implement correction manoeuvre with clinical and radiographic outcomes comparable with other percutaneous stentoplasty.
Collapse
Affiliation(s)
- Giuseppe Toro
- Department of Medical and Surgical Specialties and Dentistry, University of Campania "Luigi Vanvitelli", Naples, Italy.
| | - Francesco Langella
- Unit of Orthopaedics and Traumatology, Santa Maria della Speranza Hospital, Battipaglia, Italy
| | - Michele Gison
- Unit of Orthopaedics and Traumatology, Martiri del Villa Malta Hospital, Sarno, Italy
| | - Gabriella Toro
- Unit of Radiology and Nuclear Medicine, Santa Maria della Speranza Hospital, Battipaglia, Italy
| | - Antimo Moretti
- Department of Medical and Surgical Specialties and Dentistry, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Antonio Toro
- Unit of Orthopaedics and Traumatology, Martiri del Villa Malta Hospital, Sarno, Italy
| | - Giovanni Iolascon
- Department of Medical and Surgical Specialties and Dentistry, University of Campania "Luigi Vanvitelli", Naples, Italy
| |
Collapse
|
49
|
Engkasan JP, Ahmad-Fauzi A, Sabirin S, Chai CC, Abdul-Malek IZ, Liguori S, Moretti A, Gimigliano F. Mapping the primary outcomes reported in Cochrane systematic reviews regarding stroke with the International Classification of Functioning, Disability and Health domains: current trend and future recommendations. Eur J Phys Rehabil Med 2019; 55:378-383. [PMID: 30961345 DOI: 10.23736/s1973-9087.19.05792-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
BACKGROUND The International Classification of Functioning, Disability and Health (ICF) serves as a framework for defining and categorizing health and functioning. ICF could be used to classify research outcomes in a systematic manner. AIM The aim of this study was to classify the primary outcomes used in Cochrane Systematic Reviews (CSRs) into the ICF domains of functioning; to describe the differences in primary outcomes in reviews related to rehabilitation intervention and non-rehabilitation intervention; and to describe the trend of outcome selections according year of publication. DESIGN Methodological paper. POPULATION Adult stroke population. METHODS We analyzed the primary outcomes used in the CSRs published by the Cochrane Stroke Review Group up to December 2017. The primary outcomes were extracted and classified into the ICF domains of functioning (body functions, body structures and activity and participation). RESULTS One hundred and seventy-four papers with 216 primary outcomes were included in this analysis. Less than half (102/216, 47.2%) of the outcomes could be classified into the ICF domains of functioning. For the outcomes that could be classified into the ICF domains, the majority (72/102, 70.5%) were in the activity and participation domain, followed by body functions (26/102, 25.5%) and body structures (4/102, 4.0%). Of the outcomes that could not be classified into the ICF domains (N.=114), death (81/114, 71.1%) and recurrent stroke (21/114,18.4%) formed the majority of the outcome. There were 75 CSRs on rehabilitation related interventions; the majority of the outcomes (75/97, 77.3%) used in rehabilitation related CSRs could be classified into the ICF framework with more than half (49/75, 65.3%) in the activity and participation domain. CONCLUSIONS The majority of the primary outcomes selected by the Cochrane Stroke Review Group in their CSRs could not be classified into the ICF domains of functioning. Death and recurrence of vascular events remains the major outcome of interest. In rehabilitation related interventions, activity and participation domain is the functioning domain most commonly used. CLINICAL REHABILITATION IMPACT The systematic use of patients-centered ICF-based outcomes in CSRs could help the application of evidence in clinical decision making.
Collapse
Affiliation(s)
- Julia P Engkasan
- Department of Rehabilitation Medicine, University of Malaya, Kuala Lumpur, Malaysia -
| | - Aishah Ahmad-Fauzi
- Department of Rehabilitation Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Sakinah Sabirin
- Department of Rehabilitation Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Chau C Chai
- Department of Rehabilitation Medicine, University of Malaya, Kuala Lumpur, Malaysia
- Department of Surgery, University Malaysia Sarawak, Kota Samarahan, Malaysia
| | - Izwan Z Abdul-Malek
- Department of Rehabilitation Medicine, University of Malaya, Kuala Lumpur, Malaysia
- Department of Medicine and Health Sciences, University Putra Malaysia, Selangor, Malaysia
| | - Sara Liguori
- Department of Medical and Surgical Specialties and Dentistry, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Antimo Moretti
- Department of Medical and Surgical Specialties and Dentistry, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Francesca Gimigliano
- Department of Mental and Physical Health and Preventive Medicine, University of Campania "Luigi Vanvitelli", Naples, Italy
| |
Collapse
|
50
|
Moretti A, de Sire A, Curci C, Toro G, Gimigliano F, Iolascon G. Effectiveness of denosumab on back pain-related disability and quality-of-life in patients with vertebral fragility fractures. Curr Med Res Opin 2019; 35:151-155. [PMID: 30406685 DOI: 10.1080/03007995.2018.1545636] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Background: Denosumab is a fully human IgG2 monoclonal antibody that, neutralizing the receptor activator of nuclear factor kappa-Β ligand (RANKL), inhibits the osteoclast-mediated bone resorption. It is yet to be defined if denosumab can reduce osteoporosis-related disability and improve health-related quality-of-life (HRQoL) in patients with fragility fractures.Objective: To assess the effectiveness of denosumab in reducing back pain related disability and improving HRQoL in osteoporotic post-menopausal women with vertebral fractures.Research design and methods: A real practice prospective study was carried out, enrolling women over 50 years with a post-menopausal osteoporosis that experienced at least one vertebral fracture receiving subcutaneous denosumab (60 mg, every 6 months), calcium carbonate (500-1000 mg/day) and cholecalciferol (800 IU/day) for 1 year. Back pain related disability was assessed as the primary outcome using the Spine Pain Index (SPI); secondary outcomes were: SF-12 (Physical Health Composite Score, PCS, and Mental Health Composite Score, MCS), and EuroQol-5D (EuroQol-5D-3L index and EuroQol-Visual Analog Scale, EQ-VAS). All outcome measures were assessed at baseline (T0), after 6 months (T1), and after 12 months (T2) of treatment. Trabecular Bone Score (TBS), lumbar spine (LS) and femoral neck (FN) BMD at T0 and T2 were also evaluated.Results: This study included 140 post-menopausal women, mean age = 70.60 (SD = 8.81) years. There were statistically significant differences after 12 months (T2-T0) in all outcomes assessed: SPI (p < 0.001), SF-12 PCS (p < 0.001), SF-12 MCS (p < 0.001), EQ-5D-3L index (p = 0.039), and EQ-VAS (p = 0.003). Moreover, there was a significant improvement of both LS BMD (p < 0.001) and FN BMD (p < 0.001). No local or systemic adverse events, including new vertebral fractures, osteonecrosis of the jaw and atypical femur fractures, were reported.Conclusions: The data demonstrated that denosumab was effective in reducing back pain related disability and in improving HRQoL in post-menopausal women with vertebral fractures.
Collapse
Affiliation(s)
- Antimo Moretti
- Department of Medical and Surgical Specialties and Dentistry, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Alessandro de Sire
- Department of Medical and Surgical Specialties and Dentistry, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Claudio Curci
- Department of Medical and Surgical Specialties and Dentistry, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Giuseppe Toro
- Department of Medical and Surgical Specialties and Dentistry, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Francesca Gimigliano
- Department of Mental and Physical Health and Preventive Medicine, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Giovanni Iolascon
- Department of Medical and Surgical Specialties and Dentistry, University of Campania "Luigi Vanvitelli", Naples, Italy
| |
Collapse
|