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Tesio L, Scarano S, Caronni A. Physical and Rehabilitation Medicine: say relational or functional, not holistic. Eur J Phys Rehabil Med 2024; 60:182-189. [PMID: 38483334 PMCID: PMC11135122 DOI: 10.23736/s1973-9087.24.08309-6] [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: 11/03/2023] [Revised: 02/06/2024] [Accepted: 02/22/2024] [Indexed: 04/13/2024]
Abstract
Modern medicine tends to privilege disciplines promising "objective" laws governing body parts (from molecules to organs). Studies on a person's illness and disability are (apparently) confined to "subjectivity." The Specialty of Physical and Rehabilitation Medicine is often regarded as a humanitarian approach, belonging at best to the family of "soft," "qualitative," or "quasi-experimental" sciences. This specialty often claims specificity by labelling itself as "functional" and "holistic." However, it is shown here that the former term is acceptable, yet redundant, and the second misleading. When human behaviors and perceptions are at stake, "function" indicates a person's relationship with the outer world (already tackled by the definitional term "physical" from the Greek "physis"). The word "holistic" emphasizes mind-body unity and person-environment interdependence but, in current usage, overshadows the complementary need for an analytic, experimental approach to any function. Medicine aims at fighting disease and disability in single persons. This endeavor requires knowing body parts and mechanisms and understanding how interventions on "parts" affect the "whole." This understanding rests on the experimental method. For instance, returning to a given societal role (participation) may require restoration of walking (activity), which may require reinforcement of weakened muscular groups (impairment). Working only on holistic bio-psycho-social "wholes" may miss the therapeutic mission of medicine.
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Affiliation(s)
- Luigi Tesio
- Department of Neurorehabilitation Sciences, IRCCS Istituto Auxologico Italiano, Milan, Italy
| | - Stefano Scarano
- Department of Neurorehabilitation Sciences, IRCCS Istituto Auxologico Italiano, Milan, Italy -
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | - Antonio Caronni
- Department of Neurorehabilitation Sciences, IRCCS Istituto Auxologico Italiano, Milan, Italy
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
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2
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Tesio L, Caronni A, Simone A, Kumbhare D, Scarano S. Interpreting results from Rasch analysis 2. Advanced model applications and the data-model fit assessment. Disabil Rehabil 2024; 46:604-617. [PMID: 36744832 DOI: 10.1080/09638288.2023.2169772] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2022] [Accepted: 01/10/2023] [Indexed: 02/07/2023]
Abstract
Purpose: The present paper presents developments and advanced practical applications of Rasch's theory and statistical analysis to construct questionnaires for measuring a person's traits. The flaws of questionnaires providing raw scores are well known. Scores only approximate objective, linear measures. The Rasch Analysis allows you to turn raw scores into measures with an error estimate, satisfying fundamental measurement axioms (e.g., unidimensionality, linearity, generalizability). A previous companion article illustrated the most frequent graphic and numeric representations of results obtained through Rasch Analysis. A more advanced description of the method is presented here.Conclusions: Measures obtained through Rasch Analysis may foster the advancement of the scientific assessment of behaviours, perceptions, skills, attitudes, and knowledge so frequently faced in Physical and Rehabilitation Medicine, not less than in social and educational sciences. Furthermore, suggestions are given on interpreting and managing the inevitable discrepancies between observed scores and ideal measures (data-model "misfit"). Finally, twelve practical take-home messages for appraising published results are provided.Implications for rehabilitationThe current work is the second of two papers addressed to rehabilitation clinicians looking for an in-depth introduction to the Rasch analysis.The first paper illustrates the most common results reported in published papers presenting the Rasch analysis of questionnaires.The present article illustrates more advanced applications of the Rasch analysis, also frequently found in publications.Twelve take-home messages are given for a critical appraisal of the results.
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Affiliation(s)
- Luigi Tesio
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
- IRCCS, Istituto Auxologico Italiano, Department of Neurorehabilitation Sciences, Ospedale San Luca, Milan, Italy
| | - Antonio Caronni
- IRCCS, Istituto Auxologico Italiano, Department of Neurorehabilitation Sciences, Ospedale San Luca, Milan, Italy
| | - Anna Simone
- IRCCS, Istituto Auxologico Italiano, Department of Neurorehabilitation Sciences, Ospedale San Luca, Milan, Italy
| | - Dinesh Kumbhare
- Division of Physical Medicine and Rehabilitation, Department of Medicine, University of Toronto, Toronto, Ontario, Canada
- Pain Research Institute, Toronto Rehabilitation Institute, University Health Network, Toronto, Canada
| | - Stefano Scarano
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
- IRCCS, Istituto Auxologico Italiano, Department of Neurorehabilitation Sciences, Ospedale San Luca, Milan, Italy
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3
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Negrini S, Borg K, Cusick A, Ferriero G, Frontera WR, Gross DP, Heinemann A, Machalicek W, Moore AP, Nudo RJ, Pérennou D, Stam H, Kiekens C. Global Statements to Produce and Implement Evidence in the Post-COVID-19 Era Provide a Path Forward for Rehabilitation - A Joint Initiative of Cochrane Rehabilitation and the Leading Journals in the Field. Am J Phys Med Rehabil 2023; 102:e26-e31. [PMID: 36796420 PMCID: PMC9940826 DOI: 10.1097/phm.0000000000002155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/18/2023]
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4
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Levin SB. Contributions of Hippocratic medicine and Plato to today's debate over health, social determinants and the authority of biomedicine. MEDICAL HUMANITIES 2022:medhum-2022-012486. [PMID: 36549860 DOI: 10.1136/medhum-2022-012486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 09/06/2022] [Indexed: 06/17/2023]
Abstract
By exploring a competition for authority on health and human nature between Plato and Hippocratic medicine, this paper offers a fresh perspective on an overarching debate today involving health and the role of healthcare in its safeguarding. Economically and politically, healthcare continues to dominate the USA's handling of health, construed biophysically as the absence of disease. Yet, notoriously, in major health outcomes, the USA fares worse than other countries in the Organisation for Economic Co-operation and Development (OECD). Clearly, in giving pre-eminence to healthcare, the USA is doing far less than it could to protect and improve health. Meanwhile, mounting evidence supports the view that health impacts of social determinants besides healthcare (eg, education) surpass healthcare in heft. Circumscribed shifts in the USA's current frame will not suffice: what's needed is a change in its overall template for addressing health. Unless this is widely seen, the sway of biomedicine will likely be reduced slowly, if at all. That biomedicine's role in relation to health is raised increasingly as a question is a sign that its ongoing supremacy is not a forgone conclusion. But making the most of this opportunity requires appreciating that 'How should health's relationship to medicine be conceptualised?' is not the most fundamental query that we need to pose. Through consideration of Hippocratic medicine and Plato, I argue that the most availing answer to this particular question can come only after exploration of three larger questions involving health's status as a human good and its relationship to human flourishing. Exploration of the Greeks is, thus, valuable methodologically. What's more, it supports today's advocacy of 'health promotion', a perspective tying health closely to well-being that has yet to achieve the overall prominence that it warrants.
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Affiliation(s)
- Susan B Levin
- Philosophy, Smith College, Northampton, Massachusetts, USA
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5
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Global statements to produce and implement evidence in the post-COVID-19 era provide a path forward for rehabilitation: A joint initiative of Cochrane Rehabilitation and the leading journals in the field. Musculoskelet Sci Pract 2022; 62:102668. [PMID: 36470721 PMCID: PMC9514953 DOI: 10.1016/j.msksp.2022.102668] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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6
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Negrini S, Borg K, Cusick A, Ferriero G, Frontera WR, Gross DP, Heinemann A, Machalicek W, Moore AP, Nudo RJ, Pérennou D, Stam H, Kiekens C. Global statements to produce and implement evidence in the post-COVID-era provide a path forward for rehabilitation - A joint initiative of Cochrane Rehabilitation and the leading journals in the field. J Rehabil Med 2022; 54:jrm00345. [PMID: 36317496 PMCID: PMC9639464 DOI: 10.2340/jrm.v54.4858] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Indexed: 01/24/2023] Open
Abstract
This article is a simultaneous joint publication in Journal of Rehabilitation Medicine, Annals of Physical and Rehabilitation Medicine, American Journal of Physical Medicine & Rehabilitation, Developmental Neurorehabilitation, European Journal of Physical and Rehabilitation Medicine, Journal of Occupational Rehabilitation, Musculoskeletal Science & Practice and Neurorehabilitation and Neural Repair. The articles are identical except for stylistic changes in keeping with each journal's style. Either version may be used in citing this article.
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Affiliation(s)
- Stefano Negrini
- Department of Biomedical, Surgical and Dental Sciences, University “La Statale”, Milan, Italy,IRCCS Istituto Ortopedico Galeazzi, Milan, Italy
| | - Kristian Borg
- Department of Clinical Sciences, Karolinska Institutet Danderyd University Hospital, Stockholm, Sweden,Chief Editor Journal Rehabilitation Medicine
| | - Anne Cusick
- Discipline of Occupational Therapy, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Giorgio Ferriero
- Physical and Rehabilitation Medicine Unit, Scientific Institute of Tradate, IRCCS, Istituti Clinici Scientifici Maugeri, Tradate, Varese, Italy,Department of Biotechnology and Life Sciences, University of Insubria, Varese, Italy
| | - Walter R Frontera
- Department of Physical Medicine, Rehabilitation, and Sports Medicine and Department of Physiology, University of Puerto Rico School of Medicine, San Juan, Puerto Rico
| | - Douglas P Gross
- Department of Physical Therapy, University of Alberta, Edmonton, Canada
| | - Allen Heinemann
- Department of Physical Medicine and Rehabilitation, Feinberg School of Medicine Northwestern University, Center for Rehabilitation Outcomes Research, Shirley Ryan Abilitylab, Chicago, IL, USA
| | - Wendy Machalicek
- Department of Special Education and Clinical Sciences, College of Education, University of Oregon, Eugene, OR, USA
| | - Ann Patricia Moore
- Editor in Chief Musculoskeletal Science and Practice an International Journal of Musculoskeletal Physiotherapy,Professor Emerita, University of Brighton, Brighton, UK
| | - Randolph J Nudo
- Department of Rehabilitation Medicine, University of Kansas Medical Center, Kansas City, MO, USA
| | - Dominic Pérennou
- University Grenoble Alpes, UMR CNRS 5105 Neuropsychology and Neurocognition, CHU Grenoble Alpes, Department of Neurorehabilitation South Hospital, Cs 10217 - 38043 Grenoble cedex 9, France
| | - Henk Stam
- Chief Editor Journal Rehabilitation Medicine,Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Carlotte Kiekens
- IRCCS MultiMedica, Milan, Italy,Corresponding author. E-mail address: (C. Kiekens)
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7
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Negrini S, Borg K, Cusick A, Ferriero G, Frontera WR, Gross DP, Heinemann A, Machalicek W, Moore AP, Nudo RJ, Pérennou D, Stam H, Kiekens C. Global statements to produce and implement evidence in the post-COVID-19 era provide a path forward for rehabilitation. A joint initiative of Cochrane Rehabilitation and the leading journals in the field. Eur J Phys Rehabil Med 2022; 58:659-665. [PMID: 36217980 PMCID: PMC10019471 DOI: 10.23736/s1973-9087.22.07668-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Stefano Negrini
- Department of Biomedical, Surgical and Dental Sciences, University "La Statale", Milan, Italy.,IRCCS Istituto Ortopedico Galeazzi, Milan, Italy
| | - Kristian Borg
- Department of Clinical Sciences, Karolinska Institutet Danderyd University Hospital, Stockholm, Sweden.,Chief Editor Journal Rehabilitation Medicine
| | - Anne Cusick
- Discipline of Occupational Therapy, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Giorgio Ferriero
- Physical and Rehabilitation Medicine Unit, Scientific Institute of Tradate, IRCCS, Istituti Clinici Scientifici Maugeri, Tradate, Varese, Italy.,Department of Biotechnology and Life Sciences, University of Insubria, Varese, Italy
| | - Walter R Frontera
- Department of Physical Medicine, Rehabilitation, and Sports Medicine and Department of Physiology, University of Puerto Rico School of Medicine, San Juan, Puerto Rico
| | - Douglas P Gross
- Department of Physical Therapy, University of Alberta, Edmonton, Canada
| | - Allen Heinemann
- Department of Physical Medicine and Rehabilitation, Feinberg School of Medicine Northwestern University, Center for Rehabilitation Outcomes Research, Shirley Ryan AbilityLab, Chicago, IL, USA
| | - Wendy Machalicek
- Department of Special Education and Clinical Sciences, College of Education, University of Oregon, Eugene, OR, USA
| | - Ann P Moore
- Editor in Chief Musculoskeletal Science and Practice an International Journal of Musculoskeletal Physiotherapy.,Professor Emerita, University of Brighton, Brighton, UK
| | - Randolph J Nudo
- Department of Rehabilitation Medicine, University of Kansas Medical Center, Kansas City, MO, USA
| | - Dominic Pérennou
- University Grenoble Alpes, UMR CNRS 5105 Neuropsychology and NeuroCognition, CHU Grenoble Alpes, Department of NeuroRehabilitation South Hospital, Cs 10217 - 38043 Grenoble cedex 9, France
| | - Henk Stam
- Erasmus University Medical Center, Rotterdam, the Netherlands.,Chief Editor Journal Rehabilitation Medicine
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Global statements to produce and implement evidence in the post-COVID-era provide a path forward for rehabilitation - A joint initiative of Cochrane Rehabilitation and the leading journals in the field. Neurorehabil Neural Repair 2022; 36:567-573. [PMID: 36146945 PMCID: PMC9510938 DOI: 10.1177/15459683221125044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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9
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Negrini S, Borg K, Cusick A, Ferriero G, Frontera WR, Gross DP, Heinemann A, Machalicek W, Moore AP, Nudo RJ, Pérennou D, Stam H, Kiekens C. Global statements to produce and implement evidence in the post-COVID-19 era provide a path forward for rehabilitation - A joint initiative of Cochrane Rehabilitation and the leading journals in the field. Ann Phys Rehabil Med 2022; 65:101688. [PMID: 35811074 PMCID: PMC9359696 DOI: 10.1016/j.rehab.2022.101688] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Accepted: 06/27/2022] [Indexed: 10/31/2022]
Affiliation(s)
- Stefano Negrini
- Department of Biomedical, Surgical and Dental Sciences, University "La Statale", Milan, Italy; IRCCS Istituto Ortopedico Galeazzi, Milan, Italy
| | - Kristian Borg
- Department of Clinical Sciences, Karolinska Institutet Danderyd University Hospital, Stockholm, Sweden; Journal of Rehabilitation Medicine
| | - Anne Cusick
- Discipline of Occupational Therapy, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Giorgio Ferriero
- Physical and Rehabilitation Medicine Unit, Scientific Institute of Tradate, IRCCS, Istituti Clinici Scientifici Maugeri, Tradate, Italy; Department of Biotechnology and Life Sciences, University of Insubria, Varese, Italy
| | - Walter R Frontera
- Department of Physical Medicine, Rehabilitation, and Sports Medicine and Department of Physiology, University of Puerto Rico School of Medicine, San Juan, Puerto Rico
| | - Douglas P Gross
- Department of Physical Therapy, University of Alberta, Edmonton, AB, Canada
| | - Allen Heinemann
- Department of Physical Medicine and Rehabilitation, Feinberg School of Medicine, Northwestern University, Center for Rehabilitation Outcomes Research, Shirley Ryan AbilityLab, Chicago, IL, USA
| | - Wendy Machalicek
- Department of Special Education and Clinical Sciences, College of Education, University of Oregon, Eugene, OR, USA
| | - Ann Patricia Moore
- Musculoskeletal Science and Practice an International Journal of Musculoskeletal Physiotherapy; University of Brighton, East Sussex, UK
| | - Randolph J Nudo
- Department of Rehabilitation Medicine, University of Kansas Medical Center, Kansas City, KS, USA
| | - Dominic Pérennou
- Univ. Grenoble Alpes, UMR CNRS 5105, Neuropsychology and NeuroCognition, CHU Grenoble Alpes, Dept of NeuroRehabilitation, South Hospital, Cs 10217 - 38043, Grenoble cedex 9, France
| | - Henk Stam
- Erasmus University Medical Center Rotterdam, the Netherlands; Journal of Rehabilitation Medicine
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10
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Negrini S, Borg K, Cusick A, Ferriero G, Frontera WR, Gross DP, Heinemann A, Machalicek W, Moore AP, Nudo RJ, Pérennou D, Stam H, Kiekens C. Global statements to produce and implement evidence in the post-COVID-19 era provide a path forward for rehabilitation - A joint initiative of Cochrane Rehabilitation and the leading journals in the field. JOURNAL OF OCCUPATIONAL REHABILITATION 2022; 32:330-336. [PMID: 36205804 PMCID: PMC9542461 DOI: 10.1007/s10926-022-10071-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Affiliation(s)
- Stefano Negrini
- Department of Biomedical, Surgical and Dental Sciences, University "La Statale", Milan, Italy
- IRCCS Istituto Ortopedico Galeazzi, Milan, Italy
| | - Kristian Borg
- Department of Clinical Sciences, Karolinska Institutet Danderyd University Hospital, Stockholm, Sweden
| | - Anne Cusick
- Discipline of Occupational Therapy, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Giorgio Ferriero
- Physical and Rehabilitation Medicine Unit, Scientific Institute of Tradate, IRCCS, Istituti Clinici Scientifici Maugeri, Tradate, Italy
- Department of Biotechnology and Life Sciences, University of Insubria, Varese, Italy
| | - Walter R Frontera
- Department of Physical Medicine, Rehabilitation, and Sports Medicine and Department of Physiology, University of Puerto Rico School of Medicine, San Juan, Puerto Rico
| | - Douglas P Gross
- Department of Physical Therapy, University of Alberta, Edmonton, AB, Canada.
| | - Allen Heinemann
- Department of Physical Medicine and Rehabilitation, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
- Center for Rehabilitation Outcomes Research, Shirley Ryan AbilityLab, Chicago, IL, USA
| | - Wendy Machalicek
- Department of Special Education and Clinical Sciences, College of Education, University of Oregon, Eugene, OR, USA
| | | | - Randolph J Nudo
- Department of Rehabilitation Medicine, University of Kansas Medical Center, Kansas City, KS, USA
| | - Dominic Pérennou
- Department of NeuroRehabilitation South Hospital, Université Grenoble Alpes, Grenoble, France
| | - Henk Stam
- Erasmus University Medical Center, Rotterdam, The Netherlands
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11
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Malfitano C, Rossetti A, Scarano S, Malloggi C, Tesio L. Efficacy of Repetitive Transcranial Magnetic Stimulation for Acute Central Post-stroke Pain: A Case Study. Front Neurol 2021; 12:742567. [PMID: 34858311 PMCID: PMC8631781 DOI: 10.3389/fneur.2021.742567] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Accepted: 10/22/2021] [Indexed: 01/10/2023] Open
Abstract
Although rare, central post-stroke pain remains one of the most refractory forms of neuropathic pain. Repetitive transcranial magnetic stimulation (rTMS) has been reported to be effective in chronic cases. However, there are no data on the effects in the acute and subacute phases after stroke. In this study, we present a case of a patient with thalamic stroke with acute onset of pain and paresthesia who was responsive to rTMS. After a right thalamic stroke, a 32-year-old woman presented with drug-resistant pain and paresthesia on the left side of the body. There were no motor or sensory deficits, except for blunted thermal sensation and allodynia on light touch. Ten daily sessions were performed, where 10 Hz rTMS was applied to the hand area of the right primary motor cortex, 40 days after stroke. Before rTMS treatment (T0), immediately after treatment conclusion (T1), and 1 month after treatment (T2), three pain questionnaires were administered, and cortical responses to single and paired-pulse TMS were assessed. Eight healthy participants served as controls. At T0, when the patient was experiencing the worst pain, the excitability of the ipsilesional motor cortex was reduced. At T1 and T2, the pain scores and paresthesia' spread decreased. The clinical improvement was paralleled by the recovery in motor cortex excitability of the affected hemisphere, in terms of both intra- and inter-hemispheric connections. In this subacute central post-stroke pain case, rTMS treatment was associated with decreased pain and motor cortex excitability changes.
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Affiliation(s)
- Calogero Malfitano
- Department of Neurorehabilitation Sciences, IRCCS Istituto Auxologico Italiano, Ospedale San Luca, Milano, Italy
| | - Angela Rossetti
- Department of Neurorehabilitation Sciences, IRCCS Istituto Auxologico Italiano, Ospedale San Luca, Milano, Italy
| | - Stefano Scarano
- Department of Neurorehabilitation Sciences, IRCCS Istituto Auxologico Italiano, Ospedale San Luca, Milano, Italy.,Department of Biomedical Sciences for Health, Università Degli Studi di Milano, Milano, Italy
| | - Chiara Malloggi
- Department of Neurorehabilitation Sciences, IRCCS Istituto Auxologico Italiano, Ospedale San Luca, Milano, Italy
| | - Luigi Tesio
- Department of Neurorehabilitation Sciences, IRCCS Istituto Auxologico Italiano, Ospedale San Luca, Milano, Italy.,Department of Biomedical Sciences for Health, Università Degli Studi di Milano, Milano, Italy
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12
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Kumbhare D, Tesio L. A theoretical framework to improve the construct for chronic pain disorders using fibromyalgia as an example. Ther Adv Musculoskelet Dis 2021; 13:1759720X20966490. [PMID: 33796154 PMCID: PMC7970670 DOI: 10.1177/1759720x20966490] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Accepted: 09/22/2020] [Indexed: 11/20/2022] Open
Abstract
Fibromyalgia (FM) is a frequent, complex condition of chronic musculoskeletal pain with no evidence for biological correlates. For this reason, despite many efforts from the medical community, its construct still appears ill defined. Promising candidate biomarkers are critically reviewed. A research agenda is proposed for developing a clearer construct of FM. The ideal theoretical framework is one of overcoming the illness–disease dichotomy and considering reciprocal interactions between biology and behaviour. This approach may foster research in other fields of pain medicine and of medicine in general.
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Affiliation(s)
- Dinesh Kumbhare
- Department of Medicine, Division of Physical Medicine and Rehabilitation, University of Toronto; Pain Research Institute, Toronto Rehabilitation Institute, University Health Network, 550 University Ave, Toronto, ON M5G 2A2, Canada
| | - Luigi Tesio
- Department of Biomedical Sciences for Health, Università degli Studi di Milano, Milano, Italy
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13
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Negrini F, Malfitano C, Bertoni M, Facchi E, Ferriero G, Galeri S, Molteni F, Respizzi S, Tomba A, Beretta G, Majnardi A. The impact of COVID-19 on rehabilitation and proposal for a new organization: A report from Lombardy, Italy. THE JOURNAL OF THE INTERNATIONAL SOCIETY OF PHYSICAL AND REHABILITATION MEDICINE 2021. [DOI: 10.4103/jisprm-000108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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