Effectiveness of Kinesiotaping and McConnell taping combined with physical exercise on gait biomechanics in patients with patellofemoral syndrome: non-randomized clinical trial

Background

Patellofemoral pain syndrome (PFPS) is a pathological condition of the knee, typical of young adults, characterized by diffuse pain in the anterior and / or medial part of the knee. We aimed to examine the effectiveness of the two types of taping in association with therapeutic exercise in relation to the biomechanical parameters, on pain and on functionality of the lower limb in patients with PFPS.

Methods

We collected data from patients treated in our outpatient's clinic with two kinds of bandage: the Kinesiotaping group (KG) and the McConnel taping group (MG). All subjects were evaluated trough an optoelectronic system, the Numeric Pain Rating Scale (NPRS), and with the Lower Extremity Functional Scale (LEFS) at baseline before applying the taping (T0), fifteen minutes after applying the bandage (T1), after four weeks of treatment (T2) without applying the bandage and three months after the end of the first treatment period with bandages and exercises (T3).

Results

Thirty-five patients (KG 16; MG 19) were included in the study. The most statistically significant changes over time in the LEFS and NPRS values have been recorded in the MG group compared to KG. The average speed and hip rotation showed a statistically significant increase between T3 and T0.

Conclusion

The application of the knee bandage for PFPS would appear to show improvement in NPRS and LEFS outcomes in both groups. Furthermore, in this study the MG evidenced better results and significant changes over time than KG.

Impact of PVC microplastics on soil chemical and microbiological parameters

Microplastics (MPs) are emerging pollutants whose occurrence is a global problem in natural ecosystems including soil. Among MPs, polyvinyl chloride (PVC) is a well-known polymer with remarkable resistance to degradation, and because its recalcitrant nature serious environmental concerns are created during manufacturing and waste disposal. The effect of PVC (0.021% w/w) on chemical and microbial parameters of an agricultural soil was tested by a microcosm experiment at different incubation times (from 3 to 360 days). Among chemical parameters, soil CO₂ emission, fluorescein diacetate (FDA) activity, total organic C (TOC), total N, water extractable organic C (WEOC), water extractable N (WEN) and SUVA₂₅₄ were considered, while the structure of soil microbial communities was studied at different taxonomic levels (phylum and genus) by sequencing bacterial 16S and fungal ITS2 rDNA (Illumina MiSeq). Although some fluctuations were found, chemical and microbiological parameters exhibited some significant trends. Significant (p < 0.05) variations of soil CO₂ emission, FDA hydrolysis, TOC, WEOC and WEN were found in PVC-treated soils over different incubation times. Considering the structure of soil microbial communities, the presence of PVC significantly (p < 0.05) affected the abundances of specific bacterial and fungal taxa: Candidatus_Saccharibacteria, Proteobacteria, Actinobacteria, Acidobacteria and Bacteroides among bacteria, and Basidiomycota, Mortierellomycota and Ascomycota among fungi. After one year of experiment, a reduction of the number and the dimensions of PVC was detected supposing a possible role of microorganisms on PVC degradation. The abundance of both bacterial and fungal taxa at phylum and genus level was also affected by PVC, suggesting that the impact of this polymer could be taxa-dependent.

Efficacy of ultrasound therapy combined with cryotherapy in pain management and rehabilitation in patients with Achilles tendinopathy: a retrospective observational study

Background

Achilles tendinopathy (AT) is characterized by pain, reduced performance, and swelling in and around the tendon. The aim of our study was to evaluate and compare the effects of ultrasound therapy alone or associated with cryotherapy.

Methods

We analyzed retrospectively amateur runner patients who run at least 3 times a week, with medical and ultrasound diagnosis of subacute AT of the midportion. All patients underwent 10 sessions of ultrasounds' therapy with qmd® ultrasound cryo and a therapeutic exercise with stretching and eccentric exercises. The Cryo-Ultrasound Group (CUG, 15, 8M and7/F), during the ultrasound treatment, underwent a session of cryo-ultrasound therapy. The Ultrasound Group (UD, 15, 7M and 8F) only performed ultrasound therapy.

Results

All evaluations performed show significant improvement over time in both groups. The CUG shows at T1 a greater increase in pain and function compared to the UG. Friedmann's repeated measures analysis shows that both groups improved when assessed separately over time. From the subsequent post hoc analysis, a statistically significant difference is highlighted between the values evaluated at T0 and T3.

Conclusions

The possible simultaneous delivery of the two treatment modalities, in patients suffering from tendinopathies, therefore represents a good possibility of synergistically exploiting their therapeutic actions. Future studies with a larger patient sample and longer follow-up are also needed to better evaluate the benefits of this treatment.

Gait analysis advancements: rehabilitation value and new perspectives from forensic application

The clinical and rehabilitation value of gait analysis is remarkable and indisputable and poised to grow as technological advancements unfold. This article aims to shed light on the advances in how gait is assessed, enabling those who have suffered an injury impairing their motor skills to be diagnosed more accurately and efficiently as well as to compare the hallmarks of rehabilitative and forensic gait analysis. The authors have conducted an analysis of relevant papers (published between 1967 and 2020) from a medicolegal perspective, cited in PubMed, MEDLINE, Cochrane Library, EMBASE, and available recommendations for the legal application of such techniques. Moreover, considering the use of gait analysis as a forensic tool, this study broadens the scope of research by including search engines, legal databases, and court filings (DeJure, Lexis Nexis, Justia) between 2000 and 2022. The instrumental assessment of movement (Gait Analysis) has come to constitute an essential analytical tool for the biomedical sector to objectively and accurately assess human movement and posture. The article is also aimed at elaborating differences and similarities between clinical and forensic gait analysis. When it comes to the forensic applicability of gait analysis and its evidentiary value, however, there is a pressing need for a review of its scientific basis. Therefore, it is necessary to conduct a thorough evaluation of its use in legal practice, as stressed in scientific literature and surveys. It is of utmost importance to highlight the procedural and assessment standards currently applied to forensic gait analysis, to evaluate its strengths and weaknesses, and to achieve standardized guidelines based on broad scientific consensus.

Impact of Covid-19 pandemic on injection-based practice: report from an Italian multicenter and multidisciplinary survey

BACKGROUND

There are no papers exploring the impact of COVID-19 pandemic on the injection-based practice in patients affected by different rheumatic diseases, including osteoarthritis. The aim was to investigate the impact of COVID-19 pandemic on injection-based practice trough the Italian country.

STUDY DESIGN

A survey-based retrospective cross-sectional study.

METHODS

An Italian-language questionnaire was developed by a group of senior researchers and distributed by e-mail to some Rheumatology, Orthopedic and Rehabilitation Units from different geographic areas of Italy. The survey included information about the number of injections performed during COVID-19 pandemic (stratified by injected agents and injected joint), in comparison to the pre-pandemic period, and the possible reasons behind an eventual reduction. Responses were collected and descriptive analysis calculated.

RESULTS

Eleven centers of the National Health Service completed the survey. The activities of the injections services significantly decreased across the country with a percentage of reduction of 60% compared to the pre-pandemic period. A significant reduction of both intra-articular and peri-articular injections was registered. Among intra-articular. treatments, the most affected ones were the hyaluronic acid injections, when compared to corticosteroids. A significant decrease of the total amount of peri-articular injections was observed. The strict government restrictions and the fear of patients to become infected represented the most limiting factors.

CONCLUSIONS

The reported decrease of the injection-based practice in our country during the COVID-19 pandemic highlights the detrimental effects of the COVID-19 pandemic on the management of chronic musculoskeletal diseases with possible negative consequences in terms of disability and quality of life.

Medical management of osteoarthritis during the CO-VID-19 pandemic: a challenge for the present and the future

The ongoing Covid-19 pandemic has inevitably changed the treatment of many chronic diseases which has been suspended or has suffered dangerous slowdowns. Osteoarthritis (OA) is the most common musculoskeletal disease. As a result, the medical management of Osteoarthritis was heavily impacted by the pandemic, and it required new therapeutic strategies. The purpose of this descriptive review is to provide an overview of how much the pandemic has affected the medical management of osteoarthritis and to outline a number of possible countermeasures. The COVID-19 pandemic requires a "multimodal approach": physicians are called to test the management of Osteoarthritis patients at a distance, through the tools made available by telemedicine, for all cases in which direct contact is avoidable. Therapies that instead require a direct intervention on the patient impose that all the procedures are carried out in complete safety, scrupulously keeping to the use of personal protective equipements.

Trade-Offs with rehabilitation Effectiveness (REs) and Efficiency (REy) in a sample of Italian disabled persons in a in post-acuity rehabilitation unit

BACKGROUND

Intensive Rehabilitation Centres, known in Italy as "code 56", admit patients who need to recover from an acute episode. Different Rehabilitation Impact Indices have been proposed as composite rehabilitation outcomes measuring the rate of improvement due to a rehabilitation program. The most widely employed measure the performance of Activities of daily living in rehabilitation is the modified Barthel Index. The Barthel Index-based Rehabilitation Impact Indices are the Rehabilitation Effectiveness and the Rehabilitation Efficiency.

AIM

The aim of our study was to evaluate the trade-off between Rehabilitation Effectiveness tayand Rehabilitation Efficiency with respect to the Barthel Index admission score and the Length Of Stay, and their ideal ranges that optimized both indices.

METHODS

We retrospectively evaluated data of all patients admitted to intensive rehabilitation unit of the Scientific Institute for Research and Healthcare San Raffaele Pisana of Rome, from January 2006 to March 2018. The primary outcome measures of our study were patient's Rehabilitation Effectiveness and Rehabilitation Efficiency during the hospital stay.

RESULTS

A database of 3,466 patients was analysed and the Rehabilitation Effectiveness and Rehabilitation Efficiency indexes were calculated. We calculated the median rank ratio of the Rehabilitation Effectiveness to the Rehabilitation Efficiency against Barthel Index scores. We calculated the median rank ratio of the Rehabilitation Effectiveness to Rehabilitation Efficiency against Barthel Index scores and days of stay. The median rank ratio of the Rehabilitation Effectiveness to the Rehabilitation Efficiency value were 1 in the range of Barthel Index scores from 32 to 42. The median rank ratio of the Rehabilitation Effectiveness to Rehabilitation Efficiency value were 1 for a Length of Stay corresponding to 33 days.

CONCLUSIONS

In our study we calculated the Trade-offs between Rehabilitation Effectiveness and Rehabilitation Efficiency with respect to admission Barthel Index Score and Length Of Stay in a population of 3,466 patients affected by orthopedic (1,707) and neurological (1,759) diseases. Every member of the healthcare team should be aware of such trade-offs when they make decisions about rehabilitation services.

Idiopathic facial palsy: umbrella review of systematic reviews and meta-analyses

Idiopathic facial palsy is the most common disease of the VII cranial nerve. There are many treatments to facilitate recovery from this condition: pharmacological, surgical, rehabilitative, but the effectiveness of some of these treatments, especially the latter, is still under discussion. The purpose of this umbrella review of systematic reviews is to analyse the literature in order to investigate the different rehabilitation interventions in patients suffering from idiopathic facial palsy. A scientific literature search was carried out from January 2009 until August 2019, using Mesh the terms "facial palsy", "Bell's Palsy", "idiopathic facial nerve palsy", combined with "rehabilitation" and "therapy". Initially all the systematic reviews and meta-analyses of the last 10 years concerning rehabilitation treatments for the recovery of injured functions in facial palsy were included. Given the heterogeneity of the studies in the literature, which do not differentiate the different causes of facial palsy, all the causes of idiopathic facial palsy were included in the review. The research resulted in 94 published systematic reviews but only 6 were considered in respect to the inclusion criteria. All studies agree on the lack of high-quality scientific work to be able to say that Bell's physiotherapy treatments for facial palsy are effective, in particular with regard to recovery times during the rehabilitation process. Future studies are needed, in order to highlight the therapeutic implications of the different rehabilitation methods, with standardized protocols, in patients suffering from facial palsy of different aetiology.

Inter- and intra-interviewer reliability of Italian version of Pediatric Evaluation of Disability Inventory (I-PEDI)

BACKGROUND

Childhood disabilities determine a range of immediate and long-term economic costs that have important implications for the well-being of the child, the family and the society. The Pediatric Evaluation of Disability Inventory (PEDI) measures capability and performance in children aged between 6 months and 7.5 years. It contains three scales: Functional Skills Scales (FSS), Caregiver Assistance Scale (CAS) and Modifications Scale (MS). The present study evaluated the measurement properties of the Italian version of the PEDI (PEDI-I) in patients with spastic cerebral palsy (CP).

STUDY DESIGN

Reliability study.

METHODS

The original PEDI was translated - including a cross-cultural adaptation - into Italian. Internal consistency and test-retest reliability were evaluated.

RESULTS

Fifty-eight children with CP were recruited. According to inter-interviewer reproducibility, the FSS domain revealed intraclass correlation coefficient (ICC) values ranging between 0.94 and 1.00. CAS domain revealed ICC values ranging between 0.94 and 1.00. The SEM values ranged between 3.25 (SDD=8.98) for SF and 5.24 for SC (SDD=14.5). According to intra-interviewer reproducibility, the FSS domain revealed ICC values ranging between 0.99 and 1.00. CAS domain revealed ICC values ranging between 0.92 and 0.99. The SEM values ranged between 3.44 (SDD=9.5) for SF and 3.75 for SC (SDD=10.36). The inter-interviewer and intra-interviewer reproducibility results showed very high ICC values for both FFS and CAS domains. Cronbach's α ranged between 0.94 and 0.99, indicating excellent internal consistency within each domain of the PEDI-I.

CONCLUSION

The inter-interviewer and intra-interviewer reproducibility results of PEDI-I showed very high ICC values for FFS and CAS domains. Therefore, we recommend its application to evaluate the effect of treatment in children with CP.

Ultrasound-guided aspiration and corticosteroid injection compared to horizontal therapy for treatment of knee osteoarthritis complicated with Baker's cyst: a randomized, controlled trial

BACKGROUND

Combining different therapies, physical therapy agents, pharmacological and physical therapies, generally produces better outcomes for symptoms of knee osteoarthritis (OA) than do isolated therapies.

AIM

To demonstrate if horizontal therapy (HT) and aspiration alone and corticosteroid injection alone or in combination determine pain relief and functional improvement in a group of patients with knee OA complicated with Baker's cyst (BC).

DESIGN

We designed a randomized controlled trial (RCT).

SETTING

Outpatients.

POPULATION

Sixty patients with a knee OA and diagnosis of BC confirmed by means of standard ultrasound (US) evaluation.

METHODS

The trial was conducted as a randomized, controlled trial. Patients who satisfied the inclusion criteria were randomized to either the US-guided (Ultrasound Guided BC aspiration and corticosteroid injection group (Group A), the Horizontal Therapy group (Group B) or the US-guided BC aspiration and corticosteroid injection plus Horizontal therapy group (Group C). Outcome measures included: 1) pain reduction as measured by visual analogue scale (VAS); 2) functional improvement, as measured by WOMAC; and 3) US evaluation at baseline (T0), at one (T1) and four (T2) weeks follow-up.

RESULTS

A total of 60 patients were randomized into group A (N.=20), group B (N.=20) or Group C (N.=20). Patients in group A and in group C, but not those in group B maintained lower pain level at T2 than at baseline, with significant lower VAS values in Group C. As regards US measurements, the maximum axial area did not change as a consequence of the treatment in any of the three groups (P=0.259). Contrarily, sagittal area measurements were influenced by time (P<0.01).

CONCLUSION

Our results show that the group with the best performance for pain, functionality and dimension of BC was that in which combined use was made of horizontal and corticosteroid injection therapies.

CLINICAL REHABILITATION IMPACT

In this study we want to demonstrate the effectiveness of Horizontal Therapy in the treatment of knee OA complicated by BC.

Kinesio Taping applied to lumbar muscles influences clinical and electromyographic characteristics in chronic low back pain patients

BACKGROUND

Kinesio Taping (KT) has proved to be effective in various musculoskeletal conditions. Although its precise working mechanism has yet to be fully understood, it is believed to interact with neuromuscular function through mechanoceptor activation. No studies designed to assess the effects of KT in chronic low back pain (CLBP) patients have yet been conducted.

AIM

The aim of this study was to determine the effects of KT on pain, disability and lumbar muscle function in sufferers of CLBP, both immediately and at a one-month follow-up examination.

DESIGN

The study consisted of two phases: phase I was based on an intra-subject pre-test/post-test procedure; phase II was based on a randomized, single-blinded controlled trial.

SETTING

Outpatient facility.

POPULATION

Thirty-nine CLBP patients were enrolled.

METHODS

KT plus exercise, KT alone or exercise alone have been used for four weeks. Pain, disability and lumbar muscle function were evaluated before and after the treatment period.

RESULTS

The patients in all three groups displayed a significant reduction in pain after treatment, though only the exercise-alone group displayed reduced disability. A return to normal lumbar muscle function was observed in 28% of patients, but was not related to a reduction in pain.

CONCLUSION

When applied to CLBP patients, KT leads to pain relief and lumbar muscle function normalization shortly after its application; these effects persist over a short follow-up period.

CLINICAL REHABILITATION IMPACT

KT may represent an effective adjunct therapy in the physical rehabilitation program of CLBP patients for immediate and acute pain control.