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Coraci D, Maccarone MC, Ragazzo L, Tognolo L, Restivo DA, Santilli G, Moreira AL, Ferrara PE, Ronconi G, Masiero S. Botulinum toxin in the rehabilitation of painful syndromes: multiperspective literature analysis, lexical analysis and systematic review of randomized controlled trials. Eur J Transl Myol 2024; 34. [PMID: 38767308 DOI: 10.4081/ejtm.2024.12509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2024] [Accepted: 03/27/2024] [Indexed: 05/22/2024] Open
Abstract
Pain represents a common symptom of several diseases and is often associated with a reduction in rehabilitation outcomes and recovery. The effectiveness of pain alleviation by botulinum toxin has been recently demonstrated. We searched in PubMed the papers about this topic published in the last ten years, and we selected clinical trials, guidelines, meta-analyses, reviews, and systematic reviews. We used different approaches: multiperspective presentation, lexical evaluation, and systematic review. The systematic review was only performed for the randomized controlled trials. We predominantly found reviews and trials about the rehabilitation of stroke/brain injury and epicondylitis. The most common outcome measures were pain, function, and spasticity. Among the common words, pain was the most frequent and the terms were grouped into different families, especially concerning the outcomes. Rehabilitation showed a relatively low frequency. Finally, the systematic review showed moderate-low levels of bias which confirms the effectiveness of botulinum toxin for pain treatment. The current literature about botulinum toxin is wide and globally diffuse but with some limitations in study strategies and clearness in the formal presentation. The evidence justifies the use of botulinum toxin in treating pain in different diseases.
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Affiliation(s)
- Daniele Coraci
- Department of Neuroscience, Section of Rehabilitation, University of Padova, Padua.
| | | | - Lisa Ragazzo
- Department of Neuroscience, Section of Rehabilitation, University of Padova, Padua.
| | - Lucrezia Tognolo
- Department of Neuroscience, Section of Rehabilitation, University of Padova, Padua.
| | | | - Gabriele Santilli
- Department of Anatomical, Histological and Legal Medical Sciences and Science of the Locomotor System, Rome.
| | - Ana Lucila Moreira
- Department of Neurology, Faculdade de Medicina da Universidade de São Paulo, São Paulo.
| | | | | | - Stefano Masiero
- Department of Neuroscience, Section of Rehabilitation, University of Padova, Padua.
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Coraci D, Maccarone MC, Regazzo G, Accordi G, Papathanasiou JV, Masiero S. ChatGPT in the development of medical questionnaires. The example of the low back pain. Eur J Transl Myol 2023; 33:12114. [PMID: 38112605 PMCID: PMC10811646 DOI: 10.4081/ejtm.2023.12114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Accepted: 12/04/2023] [Indexed: 12/21/2023] Open
Abstract
In the last year, Chat Generative Pre-Trained Transformer (ChatGPT), a web software based on artificial intelligence has been showing high potential in every field of knowledge. In the medical area, its possible application is an object of many studies with promising results. We performed the current study to investigate the possible usefulness of ChatGPT in assessing low back pain. We asked ChatGPT to generate a questionnaire about this clinical condition and we compared the obtained questions and results with the ones obtained by other validated questionnaires: Oswestry Disability Index, Quebec Back Pain Disability Scale, Roland-Morris Disability Questionnaire, and Numeric Rating Scale for pain. We enrolled 20 subjects with low back pain and we found important consistencies among the validated questionnaires. The ChatGPT questionnaire showed an acceptable significant correlation only with Oswestry Disability Index and Quebec Back Pain Disability Scale. ChatGPT showed some peculiarities, especially in the assessment of quality of life and medical consultation and treatments. Our study shows that ChatGPT can help evaluate patients, including multilevel perspectives. However, its power is limited, and further research and validation are required.
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Affiliation(s)
- Daniele Coraci
- Department of Neuroscience, Section of Rehabilitation, University of Padova, Padua.
| | | | - Gianluca Regazzo
- Department of Neuroscience, Section of Rehabilitation, University of Padova, Padua.
| | - Giorgia Accordi
- Department of Neuroscience, Section of Rehabilitation, University of Padova, Padua.
| | - Jannis V Papathanasiou
- Department of Kinesiotherapy, Faculty of Public Health, Medical University of Sofia, Sofia, Bulgaria; Department of Medical Imaging, Allergology and Physiotherapy, Faculty of Dental Medicine, Medical University of Plovdiv, Plovdiv.
| | - Stefano Masiero
- Department of Neuroscience, Section of Rehabilitation, University of Padova, Padua.
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Coraci D, Romano M, Ragazzo L, Restivo DA, Cipriani M, Gottardello F, Pizzolato M, Maccarone MC, Masiero S. Rehabilitation of Peripheral Neuropathies: From Lexical Analysis of the Literature to Identification of Clinical Protocols. J Clin Med 2023; 12:5879. [PMID: 37762819 PMCID: PMC10531665 DOI: 10.3390/jcm12185879] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Revised: 08/30/2023] [Accepted: 09/06/2023] [Indexed: 09/29/2023] Open
Abstract
Peripheral nervous system diseases are a complex and heterogenous group of diseases affecting the different nerves with various severity and impact on quality of life. The current literature does not provide a structured guide for the rehabilitation of these conditions. We performed a lexical literature evaluation based on graph theory to clarify this topic. We performed a search on PubMed and calculated the frequencies of the words indicating rehabilitation approaches, nerves, and diseases. We found the usefulness of exercises and different physical agents, like laser and ultrasound therapy and neuromuscular stimulation vibration therapy. Orthoses are useful for entrapment, trauma, and hereditary diseases. Correct knowledge and assessment of the neuropathies are fundamental for the therapeutic decision and to guide rehabilitation. Despite the usefulness shown by the different approaches to modulating pain, improving muscle strength and endurance, and ameliorating balance and the sensory system, further studies are needed to define the best-personalized protocols.
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Affiliation(s)
- Daniele Coraci
- Department of Neuroscience, Section of Rehabilitation, University of Padova, Via Nicolò Giustiniani, 2, 35128 Padua, Italy; (L.R.); (M.C.); (F.G.); (M.P.); (S.M.)
| | - Marcello Romano
- Neurology Unit, Azienda Ospedaliera Ospedali Riuniti Villa Sofia Cervello, 90146 Palermo, Italy;
| | - Lisa Ragazzo
- Department of Neuroscience, Section of Rehabilitation, University of Padova, Via Nicolò Giustiniani, 2, 35128 Padua, Italy; (L.R.); (M.C.); (F.G.); (M.P.); (S.M.)
| | - Domenico Antonio Restivo
- Department of Clinical and Experimental Medicine, University of Messina, Piazza Pugliatti, 1, 98122 Messina, Italy;
| | - Martina Cipriani
- Department of Neuroscience, Section of Rehabilitation, University of Padova, Via Nicolò Giustiniani, 2, 35128 Padua, Italy; (L.R.); (M.C.); (F.G.); (M.P.); (S.M.)
| | - Federica Gottardello
- Department of Neuroscience, Section of Rehabilitation, University of Padova, Via Nicolò Giustiniani, 2, 35128 Padua, Italy; (L.R.); (M.C.); (F.G.); (M.P.); (S.M.)
| | - Martina Pizzolato
- Department of Neuroscience, Section of Rehabilitation, University of Padova, Via Nicolò Giustiniani, 2, 35128 Padua, Italy; (L.R.); (M.C.); (F.G.); (M.P.); (S.M.)
| | - Maria Chiara Maccarone
- Physical Medicine and Rehabilitation School, University of Padova, Via Nicolò Giustiniani, 2, 35128 Padua, Italy;
| | - Stefano Masiero
- Department of Neuroscience, Section of Rehabilitation, University of Padova, Via Nicolò Giustiniani, 2, 35128 Padua, Italy; (L.R.); (M.C.); (F.G.); (M.P.); (S.M.)
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Castro JCD, Wang D, Chien GCC. Regenerative medicine for neuropathic pain: physiology, ultrasound and therapies with a focus on alpha-2-macroglobulin. Pain Manag 2022; 12:779-793. [PMID: 35762220 DOI: 10.2217/pmt-2022-0006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
The currently available drugs to treat neuropathic pain do not provide adequate pain management. As such, other treatments including stem cells, platelet-rich plasma and plasma-derived molecules such as alpha-2 macroglobulin (A2M) are being explored because they show promising potential for neuropathic pain. The various mechanisms and immunomodulatory effects could be a desirable approach in targeting neuropathic pain. This review indicates that A2M can be highly efficacious due to its conformational change during activation and specificity of action on various cytokines. Its ability to reduce neuropathic pain can further the future of neuropathic intervention. However, there is a lack of robust clinical studies and thus further research is needed to verify and expand the understanding of its therapeutic effects.
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Affiliation(s)
- Jeimylo C de Castro
- Department of Physical Medicine & Rehabilitation, The Medical City-South Luzon, Santa Rosa, Laguna, 4026, Philippines.,SMARTMD Center for Non-Surgical Pain Interventions, Makati, 1224, Philippines
| | - Daniel Wang
- Kansas City University, Kansas City, MO 64106, USA
| | - George C Chang Chien
- Pain Management, Ventura County Medical Center, Ventura, CA 93003, USA.,GCC Institute for Regenerative Medicine, Irvine, CA 92606, USA
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