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Giorgi V, Apostolo G, Bertelè L. Treating Dystonia in a Soccer Player Through an Integrated Rehabilitative Approach: A Case Report. J Sport Rehabil 2024; 33:365-375. [PMID: 38702050 DOI: 10.1123/jsr.2023-0100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Revised: 02/24/2024] [Accepted: 03/19/2024] [Indexed: 05/06/2024]
Abstract
CONTEXT Sport-related dystonia is a rare form of activity-specific dystonia that can severely impair an athlete's ability to perform. Due to a lack of data on the condition, it is difficult to diagnose and often overlooked, and no gold standard treatment has yet been defined. CASE PRESENTATION We present a rare and challenging case of sport-related dystonia that affected a 24-year-old male professional soccer player. The patient presented with severe rigidity and dystonia of the right lower-extremity, particularly the ankle and foot. The symptoms set on >1 year prior to the presentation to our outpatient clinic. He began to complain of stiffness and difficulty moving his lower limbs, especially his right leg, initially when playing soccer, but then also when walking normally. On presentation, he was unable to run and walked with difficulty, supporting his body weight only on the outside of his right foot. He also reported a motor trick and reverse motor trick involving the oral musculature in order to move his lower limb more freely. MANAGEMENT AND OUTCOMES An integrated rehabilitation approach based on postural rehabilitation, neuromuscular rehabilitation, and dental intervention was used to successfully treat this condition. The approach included: (1) postural rehabilitation with the Mézières-Bertelè method to reduce muscular stiffness, (2) neuromuscular re-education with Tai Chi exercises and electromyography-guided biofeedback, and (3) dental intervention and swallowing rehabilitation to limit impaired oral habits (due to the relationship between his impaired lower limb movements and motor tricks of the oral musculature). After 7 months of integrated rehabilitation, the patient returned to professional soccer. CONCLUSIONS This case report highlights the potential efficacy of an integrative rehabilitation approach for sports dystonia, particularly in cases where traditional treatments may not be effective. Such an approach could be considered a valuable option in the management of this rare, but debilitating, condition in athletes. Further research is needed to assess the effectiveness of this approach in larger populations.
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Affiliation(s)
- Valeria Giorgi
- Rehabilitation Center, Apostolo Foundation, Merate, Italy
- Unità di Ricerca Clinica, Gruppo Ospedaliero Moncucco, Lugano, Switzerland
| | | | - Laura Bertelè
- Rehabilitation Center, Apostolo Foundation, Merate, Italy
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Giorgi V, Apostolo G, Bertelè L. Treatment of developmental hip dysplasia with manual therapy following Pavlik harness failure: a case report with long-term follow-up. J Man Manip Ther 2024; 32:352-361. [PMID: 38706305 PMCID: PMC11216241 DOI: 10.1080/10669817.2024.2349334] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2024] [Accepted: 04/24/2024] [Indexed: 05/07/2024] Open
Abstract
BACKGROUND Developmental dysplasia of the hip (DDH) is a common musculoskeletal disorder in newborns, ranging from mild dysplasia to complete dislocation. Early detection and intervention are crucial for managing DDH. However, in some cases, standard orthopedic treatments such as the Pavlik harness fail, and alternative approaches are needed. Our study explores the possibility that manual therapy, specifically the Mézières-Bertelè Method (MBM), could be beneficial in cases of DDH that are resistant to conventional treatments. CASE DESCRIPTION We present a case of a 20-month-old female who had been suffering from persistent DDH (Graf's type IIIC on the left), pain and limping, despite previous conventional treatments, including the Pavlik harness. The patient received daily MBM sessions for six months, followed by maintenance sessions every two months. OUTCOMES After undergoing the MBM treatment, the patient showed clinical improvements, such as normal neuromotor development and restored hip joint parameters. We observed normal walking and running abilities, and X-ray parameters returned to normal levels. The patient sustained positive outcomes during long-term follow-up until the age of 7. CONCLUSION The MBM manual therapy was used to treat a challenging case of DDH resistant to conventional treatment. This case report suggests a possible correlation between manual therapy and improved outcomes in resistant DDH and highlights the potential relevance of addressing the inherent musculoskeletal components of the condition.
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Affiliation(s)
- Valeria Giorgi
- Rehabilitation Center, Apostolo Foundation, Lecco, Italy
| | | | - Laura Bertelè
- Rehabilitation Center, Apostolo Foundation, Lecco, Italy
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Alfonso-Mora ML, Guerra-Balic M, Sánchez-Martín R, Pedraza-Gómez Z, Ramírez-Moreno J, Castellanos-Garrido AL, Zambrano-Cristancho LK, Rengifo Varona ML. Mézières Method as a practice of embodiment in patients with low back pain: a mixed study. Ann Med 2023; 55:2265379. [PMID: 37847998 PMCID: PMC10583626 DOI: 10.1080/07853890.2023.2265379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Accepted: 09/27/2023] [Indexed: 10/19/2023] Open
Abstract
INTRODUCTION The objectives of this study were to determine the effects of the Mézières Method (MM) on pain and disability related to low back pain (LBP), compared to a program of heat, massage and exercise, and to understand the meaning of the bodily experience with the MM. PATIENTS AND METHODS Mixed methods convergent parallel design, combining an equivalent randomized clinical trial with a qualitative phenomenological approach. Sixty-one participants aged 18-65 years with chronic non-specific LBP lasting more than 3 months. Patients were randomized into two groups: the MM group (n = 29) and the comparison group (CG) who received heat, massage plus flexibility and strengthening exercises (n = 31). MM and CG participants underwent 10 one-hour physical therapy sessions over a 5-week period and were evaluated three times: pre-intervention, post-intervention and follow-up at 6 weeks after the end of treatment. RESULTS Both groups reported positive effects on LBP . MM group showed superior effects in pain relief in the short term (Cohen's D 0.80; p = 0.004). Participants interpreted the interaction with the MM as a teaching-learning process that allowed body awareness. CONCLUSION Both treatment were similarly beneficial but MM had superior effects on pain in the short term. MM is perceived by the participants as a teaching-learning process focused on body awareness that facilitate effective management of LBP.
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Affiliation(s)
- Margareth Lorena Alfonso-Mora
- Universidad de La Sabana, Chía, Colombia
- Blanquerna School of Psychology, Educational Sciences and Sports, Ramon Llull University, Barcelona, Spain
| | - Miriam Guerra-Balic
- Blanquerna School of Psychology, Educational Sciences and Sports, Ramon Llull University, Barcelona, Spain
| | - Ricardo Sánchez-Martín
- Blanquerna School of Psychology, Educational Sciences and Sports, Ramon Llull University, Barcelona, Spain
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Alfonso-Mora ML, Ramírez-Moreno J, Guerra-Balic M, Sánchez-Martín R, Castellanos AL, Rengifo ML. Effects and experience with the Mézières method in people with low back pain: A mixed methods study. J Back Musculoskelet Rehabil 2022; 35:485-493. [PMID: 34542058 DOI: 10.3233/bmr-200344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND Low back pain (LBP) is one of the most common reasons for visiting the doctor. The Mézières method (MM) emphasises body awareness and uses a global postural rehabilitation approach. It is used in the management of LBP, but its effectiveness has received limited formal evaluation. OBJECTIVE To determine the effects of MM on quality of life, pain and functional disability in people with LBP and understand the patient's bodily experience during the MM intervention. METHODS This protocol study of single-blind randomised controlled trial with a mixed methods design will include 54 people with LBP aged 18 to 65 years. Participants will be randomised into two groups, one will receive MM and the other will receive a control intervention, administered through 10 treatment sessions. Participants will also construct a narrative to provide an understanding of their bodily experience. RESULTS The assessed outcomes will include pain, back pain-related disability assessed using the Roland Morris Questionnaire, and quality of life related to health assessed using the SF12. Outcomes will be assessed at baseline, after the intervention and at a 6 weeks follow-up.
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Affiliation(s)
- Margareth Lorena Alfonso-Mora
- Faculty of Psychology, Blanquerna Education and Sport Sciences, Universidad Ramón Llull, Barcelona, Spain.,Physiotherapy Program, Universidad de La Sabana, Chia, Colombia
| | | | - Miriam Guerra-Balic
- Faculty of Psychology, Blanquerna Education and Sport Sciences, Universidad Ramón Llull, Barcelona, Spain
| | - Ricardo Sánchez-Martín
- Faculty of Psychology, Blanquerna Education and Sport Sciences, Universidad Ramón Llull, Barcelona, Spain
| | | | - María Leonor Rengifo
- Trauma and Clinical Rehabilitation, Clínica Universidad de La Sabana, Chia, Colombia
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Giustino V, Messina G, Patti A, Padua E, Zangla D, Drid P, Battaglia G, Palma A, Bianco A. Effects of a Postural Exercise Program on Vertical Jump Height in Young Female Volleyball Players with Knee Valgus. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19073953. [PMID: 35409635 PMCID: PMC8997520 DOI: 10.3390/ijerph19073953] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Revised: 03/22/2022] [Accepted: 03/24/2022] [Indexed: 02/06/2023]
Abstract
Background: Although a knee valgus position is related to the increase in injury risk in volleyball players, there is a lack of studies on the relationship between knee valgus and vertical jump (VJ) performance. Hence, the aim of this study was to investigate the effects of a postural exercise program on VJ height in young female volleyball players with knee valgus. Methods: This pilot study included 19 young female volleyball players divided into the following groups: the Valgus Experimental Group (VEG); the Valgus Control Group (VCG); and the Neutral Control Group (NCG). All three groups carried out the same volleyball training program. In addition, only the VEG underwent a 3-month postural exercise program of 30–45 min/session, twice/week. VJ performance was measured through the Sargent test before (T0), at 6 weeks (T1), and at 12 weeks (T2). Results: A significant effect from T0 to T1 (p = 0.0017) and from T0 to T2 (p = 0.0001) was found in the VEG. No significant differences were found over time in the VCG and in the NCG. Conclusion: An integrated postural exercise program might lead to a more balanced muscle efficiency inducing athletes to obtain a higher VJ performance.
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Affiliation(s)
- Valerio Giustino
- Sport and Exercise Sciences Research Unit, Department of Psychology, Educational Science and Human Movement, University of Palermo, 90144 Palermo, Italy; (V.G.); (G.M.); (D.Z.); (G.B.); (A.P.); (A.B.)
| | - Giuseppe Messina
- Sport and Exercise Sciences Research Unit, Department of Psychology, Educational Science and Human Movement, University of Palermo, 90144 Palermo, Italy; (V.G.); (G.M.); (D.Z.); (G.B.); (A.P.); (A.B.)
| | - Antonino Patti
- Sport and Exercise Sciences Research Unit, Department of Psychology, Educational Science and Human Movement, University of Palermo, 90144 Palermo, Italy; (V.G.); (G.M.); (D.Z.); (G.B.); (A.P.); (A.B.)
- Correspondence:
| | - Elvira Padua
- Department of Human Sciences and Promotion of Quality of Life, San Raffaele Roma Open University, 00166 Rome, Italy;
| | - Daniele Zangla
- Sport and Exercise Sciences Research Unit, Department of Psychology, Educational Science and Human Movement, University of Palermo, 90144 Palermo, Italy; (V.G.); (G.M.); (D.Z.); (G.B.); (A.P.); (A.B.)
| | - Patrik Drid
- Faculty of Sport and Physical Education, University of Novi Sad, 21000 Novi Sad, Serbia;
| | - Giuseppe Battaglia
- Sport and Exercise Sciences Research Unit, Department of Psychology, Educational Science and Human Movement, University of Palermo, 90144 Palermo, Italy; (V.G.); (G.M.); (D.Z.); (G.B.); (A.P.); (A.B.)
| | - Antonio Palma
- Sport and Exercise Sciences Research Unit, Department of Psychology, Educational Science and Human Movement, University of Palermo, 90144 Palermo, Italy; (V.G.); (G.M.); (D.Z.); (G.B.); (A.P.); (A.B.)
| | - Antonino Bianco
- Sport and Exercise Sciences Research Unit, Department of Psychology, Educational Science and Human Movement, University of Palermo, 90144 Palermo, Italy; (V.G.); (G.M.); (D.Z.); (G.B.); (A.P.); (A.B.)
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Musculoskeletal Pain in Gymnasts: A Retrospective Analysis on a Cohort of Professional Athletes. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18105460. [PMID: 34065250 PMCID: PMC8160814 DOI: 10.3390/ijerph18105460] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Revised: 05/14/2021] [Accepted: 05/16/2021] [Indexed: 11/16/2022]
Abstract
Gymnastics athletes are exposed to a high risk of injury, but also of developing musculoskeletal pain. These data are still little investigated in the available scientific literature. An online survey was distributed to 79 professional athletes who practiced artistic and rhythmic gymnastics. The survey collected demographic and anthropometric data, information about the sport practice, the training sessions, the prevalence of musculoskeletal pain gymnastics-related, and lifestyle habits. Musculoskeletal pain had a high prevalence, involving 65 of 79 athletes (82.3%). A significant correlation was found between musculoskeletal pain and the duration of sports practice, both for general pain (p = 0.041) and for specific districts: right wrist pain (p = 0.031), left wrist pain (p = 0.028), right shoulder (p = 0.039), left hip (p = 0.031), right thigh (p = 0.031), and left knee (p = 0.005). Another statistical association was found between right wrist pain and BMI (p = 0.001), and hip pain and BMI (p = 0.030). Hours spent in a sitting position were also correlated with the incidence of pain (p = 0.045). Wrist pain and right shoulder pain had a statistically significant association with the age of the athletes (right wrist pain: p = 0.038; left wrist pain: p = 0.004; right shoulder pain: p = 0.035). The more the gymnasts practice this sport, the more likely they are to develop musculoskeletal pain. Increased age and a higher BMI, as well as daily prolonged sitting position, seem to be potential risk factors for the onset of musculoskeletal pain. Future studies could plan training strategies aimed at preventing musculoskeletal pain associated with gymnastics, in order to promote its further spread.
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