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Origo D, Buffone F, Montini G, Belluto D, Tramontano M, Dal Farra F. Foot Posture Index Does Not Correlate with Dynamic Foot Assessment Performed via Baropodometric Examination: A Cross-Sectional Study. Healthcare (Basel) 2024; 12:814. [PMID: 38667576 PMCID: PMC11050396 DOI: 10.3390/healthcare12080814] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2024] [Revised: 03/29/2024] [Accepted: 04/08/2024] [Indexed: 04/28/2024] Open
Abstract
BACKGROUND Clinicians employ foot morphology assessment to evaluate the functionality of the method and anticipate possible injuries. This study aims to correlate static foot posture and the dynamic barefoot evaluation in a sample of healthy adult participants. METHODS The foot posture was evaluated using the Foot Posture Index-6 (FPI-6) and the dynamics were evaluated through baropodometric examination. Two operators independently assessed the participants' foot posture through FPI-6, and then a dynamic evaluation was performed by asking them to walk 8 times across a platform. One hundred participants (mean age: 32.15 ± 7.49) were enrolled. RESULTS The inter-rater agreement between the two assessors was found to be excellent. The majority of the feet belonged to the 0 < FPI < 4 class (32%), followed by the 4 < FPI < 8 (31%) and the FPI > 8 ranges (19.5%). Our "area of contact" analysis showed a significant poor correlation between FPI and total foot, midfoot, and the second metatarsophalangeal joint (MTPJ) (-0.3 < r < 0). Regarding "force" parameters, the analysis showed a poor correlation between the midfoot, hallux, and the second toe (-0.2 < r < 2); finally the "pressure" analysis showed a poor correlation between FPI, the fourth MTPJ, and the second toe (-0.2 < rs < 0.3) and a moderate correlation between the hallux (r = 0.374) and the fifth MTPJ (r = 0.427). CONCLUSIONS This study emphasizes the constrained correlation between static foot posture observation and dynamic barefoot examination.
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Affiliation(s)
- Daniele Origo
- Department of Research, SOMA Osteopathic Institute Milan, 20126 Milan, Italy; (D.O.); (F.B.); (G.M.); (D.B.); (F.D.F.)
| | - Francesca Buffone
- Department of Research, SOMA Osteopathic Institute Milan, 20126 Milan, Italy; (D.O.); (F.B.); (G.M.); (D.B.); (F.D.F.)
- Division of Pediatric, Manima Non-Profit Organization Social Assistance and Healthcare, 20125 Milan, Italy
- Principles and Practice of Clinical Research (PPCR), Harvard T.H. Chan School of Public Health–ECPE, Boston, MA 02115, USA
| | - Gabriele Montini
- Department of Research, SOMA Osteopathic Institute Milan, 20126 Milan, Italy; (D.O.); (F.B.); (G.M.); (D.B.); (F.D.F.)
| | - Daniele Belluto
- Department of Research, SOMA Osteopathic Institute Milan, 20126 Milan, Italy; (D.O.); (F.B.); (G.M.); (D.B.); (F.D.F.)
| | - Marco Tramontano
- Department of Biomedical and Neuromotor Sciences (DIBINEM), Alma Mater University of Bologna, 40126 Bologna, Italy
- Unit of Occupational Medicine, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy
| | - Fulvio Dal Farra
- Department of Research, SOMA Osteopathic Institute Milan, 20126 Milan, Italy; (D.O.); (F.B.); (G.M.); (D.B.); (F.D.F.)
- Department Information Engineering, University of Brescia, Via Branze 38, 25123 Brescia, Italy
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Vismara L, Ferraris C, Amprimo G, Pettiti G, Buffone F, Tarantino AG, Mauro A, Priano L. Exergames as a rehabilitation tool to enhance the upper limbs functionality and performance in chronic stroke survivors: a preliminary study. Front Neurol 2024; 15:1347755. [PMID: 38390596 PMCID: PMC10883060 DOI: 10.3389/fneur.2024.1347755] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Accepted: 01/22/2024] [Indexed: 02/24/2024] Open
Abstract
Introduction Post-stroke hemiplegia commonly occurs in stroke survivors, negatively impacting the quality of life. Despite the benefits of initial specific post-acute treatments at the hospitals, motor functions, and physical mobility need to be constantly stimulated to avoid regression and subsequent hospitalizations for further rehabilitation treatments. Method This preliminary study proposes using gamified tasks in a virtual environment to stimulate and maintain upper limb mobility through a single RGB-D camera-based vision system (using Microsoft Azure Kinect DK). This solution is suitable for easy deployment and use in home environments. A cohort of 10 post-stroke subjects attended a 2-week gaming protocol consisting of Lateral Weightlifting (LWL) and Frontal Weightlifting (FWL) gamified tasks and gait as the instrumental evaluation task. Results and discussion Despite its short duration, there were statistically significant results (p < 0.05) between the baseline (T0) and the end of the protocol (TF) for Berg Balance Scale and Time Up-and-Go (9.8 and -12.3%, respectively). LWL and FWL showed significant results for unilateral executions: rate in FWL had an overall improvement of 38.5% (p < 0.001) and 34.9% (p < 0.01) for the paretic and non-paretic arm, respectively; similarly, rate in LWL improved by 19.9% (p < 0.05) for the paretic arm and 29.9% (p < 0.01) for non-paretic arm. Instead, bilateral executions had significant results for rate and speed: considering FWL, there was an improvement in rate with p < 0.01 (31.7% for paretic arm and 37.4% for non-paretic arm), whereas speed improved by 31.2% (p < 0.05) and 41.7% (p < 0.001) for the paretic and non-paretic arm, respectively; likewise, LWL showed improvement in rate with p < 0.001 (29.0% for paretic arm and 27.8% for non-paretic arm) and in speed with 23.6% (p < 0.05) and 23.5% (p < 0.01) for the paretic and non-paretic arms, respectively. No significant results were recorded for gait task, although an overall good improvement was detected for arm swing asymmetry (-22.6%). Hence, this study suggests the potential benefits of continuous stimulation of upper limb function through gamified exercises and performance monitoring over medium-long periods in the home environment, thus facilitating the patient's general mobility in daily activities.
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Affiliation(s)
- Luca Vismara
- Division of Neurology and Neurorehabilitation, Istituto Auxologico Italiano IRCCS, S. Giuseppe Hospital, Piancavallo, Italy
| | - Claudia Ferraris
- Institute of Electronics, Information Engineering and Telecommunication, National Research Council, Turin, Italy
| | - Gianluca Amprimo
- Institute of Electronics, Information Engineering and Telecommunication, National Research Council, Turin, Italy
- Department of Control and Computer Engineering, Politecnico di Torino, Turin, Italy
| | - Giuseppe Pettiti
- Institute of Electronics, Information Engineering and Telecommunication, National Research Council, Turin, Italy
| | - Francesca Buffone
- Division of Paediatric, Manima Non-Profit Organization Social Assistance and Healthcare, Milan, Italy
- Principles and Practice of Clinical Research, Harvard T.H. Chan School of Public Health-ECPE, Boston, MA, United States
| | | | - Alessandro Mauro
- Division of Neurology and Neurorehabilitation, Istituto Auxologico Italiano IRCCS, S. Giuseppe Hospital, Piancavallo, Italy
- Department of Neurosciences "Rita Levi Montalcini", University of Turin, Turin, Italy
| | - Lorenzo Priano
- Division of Neurology and Neurorehabilitation, Istituto Auxologico Italiano IRCCS, S. Giuseppe Hospital, Piancavallo, Italy
- Department of Neurosciences "Rita Levi Montalcini", University of Turin, Turin, Italy
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Vismara L, Bergna A, Tarantino AG, Dal Farra F, Buffone F, Vendramin D, Cimolin V, Cerfoglio S, Pradotto LG, Mauro A. Reliability and Validity of the Variability Model Testing Procedure for Somatic Dysfunction Assessment: A Comparison with Gait Analysis Parameters in Healthy Subjects. Healthcare (Basel) 2024; 12:175. [PMID: 38255064 PMCID: PMC10815658 DOI: 10.3390/healthcare12020175] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Revised: 12/28/2023] [Accepted: 01/08/2024] [Indexed: 01/24/2024] Open
Abstract
Somatic dysfunction (SD) is an altered body function involving the musculoskeletal system. However, its clinical signs-tissue texture abnormalities, positional asymmetry, restricted range of motion, and tissue tenderness-did not achieve satisfactory results for reliability. A recent theoretical model proposed a revision assessing the movement variability around the joint rest position. The asymmetry and restriction of motion may characterize functional assessment in osteopathic clinical practice, demonstrating the reliability required. Hence, this study investigated the reliability of the new variability model (VM) with gait analysis (GA). Three blind examiners tested 27 young healthy subjects for asymmetry of motion around rest position and the SD grade on six body regions. The results were compared to the VICON procedure for 3D-GA. The inter-rater agreement for the detection of reduced movement variability ranged from 0.78 to 0.54, whereas for SD, grade ranged from 0.64 to 0.47. VM had a sensitivity and specificity of 0.62 and 0.53, respectively, in SD detection compared to step length normality. Global severity grade of SD demonstrated moderate to good correlation with spatial-temporal parameters. The VM showed palpatory reliability and validity with spatial-temporal parameters in GA. Those findings contribute to the innovation for SD examination with implications for the clinical practice.
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Affiliation(s)
- Luca Vismara
- Division of Neurology and Neurorehabilitation—IRCCS Istituto Auxologico Italiano, Strada Luigi Cadorna 90, 28824 Piancavallo-Verbania, Italy; (L.V.); (V.C.); (S.C.); (L.G.P.); (A.M.)
| | - Andrea Bergna
- Department of Research, SOMA Istituto Osteopatia Milano—Institute Osteopathy Milan, 20126 Milan, Italy; (A.B.); (A.G.T.); (F.D.F.)
| | - Andrea Gianmaria Tarantino
- Department of Research, SOMA Istituto Osteopatia Milano—Institute Osteopathy Milan, 20126 Milan, Italy; (A.B.); (A.G.T.); (F.D.F.)
- Division of Paediatric, Manima Non-Profit Organization Social Assistance and Healthcare, 20125 Milan, Italy;
| | - Fulvio Dal Farra
- Department of Research, SOMA Istituto Osteopatia Milano—Institute Osteopathy Milan, 20126 Milan, Italy; (A.B.); (A.G.T.); (F.D.F.)
- Department of Information Engineering, University of Brescia, 25123 Brescia, Italy
| | - Francesca Buffone
- Department of Research, SOMA Istituto Osteopatia Milano—Institute Osteopathy Milan, 20126 Milan, Italy; (A.B.); (A.G.T.); (F.D.F.)
- Division of Paediatric, Manima Non-Profit Organization Social Assistance and Healthcare, 20125 Milan, Italy;
- Principles and Practice of Clinical Research (PPCR), Harvard T.H. Chan School of Public Health–ECPE, Boston, MA 02115, USA
| | - Davide Vendramin
- Division of Paediatric, Manima Non-Profit Organization Social Assistance and Healthcare, 20125 Milan, Italy;
| | - Veronica Cimolin
- Division of Neurology and Neurorehabilitation—IRCCS Istituto Auxologico Italiano, Strada Luigi Cadorna 90, 28824 Piancavallo-Verbania, Italy; (L.V.); (V.C.); (S.C.); (L.G.P.); (A.M.)
- Department of Electronics, Information and Bioengineering, Politecnico di Milano, Piazza Leonardo da Vinci 32, 20133 Milan, Italy
| | - Serena Cerfoglio
- Division of Neurology and Neurorehabilitation—IRCCS Istituto Auxologico Italiano, Strada Luigi Cadorna 90, 28824 Piancavallo-Verbania, Italy; (L.V.); (V.C.); (S.C.); (L.G.P.); (A.M.)
- Department of Electronics, Information and Bioengineering, Politecnico di Milano, Piazza Leonardo da Vinci 32, 20133 Milan, Italy
| | - Luca Guglielmo Pradotto
- Division of Neurology and Neurorehabilitation—IRCCS Istituto Auxologico Italiano, Strada Luigi Cadorna 90, 28824 Piancavallo-Verbania, Italy; (L.V.); (V.C.); (S.C.); (L.G.P.); (A.M.)
- Department of Neurosciences “Rita Levi Montalcini”, University of Turin, 10126 Turin, Italy
| | - Alessandro Mauro
- Division of Neurology and Neurorehabilitation—IRCCS Istituto Auxologico Italiano, Strada Luigi Cadorna 90, 28824 Piancavallo-Verbania, Italy; (L.V.); (V.C.); (S.C.); (L.G.P.); (A.M.)
- Department of Neurosciences “Rita Levi Montalcini”, University of Turin, 10126 Turin, Italy
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Dal Farra F, Buffone F, Risio RG, Tarantino A, Vismara L, Bergna A. Reply to the letter sent by Ceballos-Laitaa et al. Complement Ther Clin Pract 2023; 53:101790. [PMID: 37516598 DOI: 10.1016/j.ctcp.2023.101790] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/31/2023]
Affiliation(s)
- F Dal Farra
- Department of Research, Institute Osteopathy Milan, Istituto Osteopatia Milano (SOMA), 20126, Milan, Italy
| | - F Buffone
- Department of Research, Institute Osteopathy Milan, Istituto Osteopatia Milano (SOMA), 20126, Milan, Italy; Division of Paediatric, Manima Non-Profit Organization Social Assistance and Healthcare, 20125, Milan, Italy; Principles and Practice of Clinical Research (PPCR), Harvard T.H. Chan School of Public Health-ECPE, Boston, MA, 02115, USA.
| | - R G Risio
- Department of Research, Institute Osteopathy Milan, Istituto Osteopatia Milano (SOMA), 20126, Milan, Italy
| | - A Tarantino
- Department of Research, Institute Osteopathy Milan, Istituto Osteopatia Milano (SOMA), 20126, Milan, Italy; Division of Paediatric, Manima Non-Profit Organization Social Assistance and Healthcare, 20125, Milan, Italy
| | - L Vismara
- Division of Neurology and Neurorehabilitation - IRCCS Istituto Auxologico Italiano, Strada Luigi Cadorna 90, 28824, Piancavallo-Verbania, Italy
| | - A Bergna
- Department of Research, Institute Osteopathy Milan, Istituto Osteopatia Milano (SOMA), 20126, Milan, Italy
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Buffone F, Tarantino AG, Belloni F, Spadafora A, Bolzoni G, Bruini I, Bergna A, Vismara L. Effectiveness of Osteopathic Manipulative Treatment in Adults with Irritable Bowel Syndrome: A Systematic Review and Meta-Analysis. Healthcare (Basel) 2023; 11:2442. [PMID: 37685480 PMCID: PMC10487478 DOI: 10.3390/healthcare11172442] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Revised: 08/27/2023] [Accepted: 08/28/2023] [Indexed: 09/10/2023] Open
Abstract
The aim of this systematic review and meta-analysis was to evaluate the effectiveness of the osteopathic manipulative treatment (OMT) in adults with irritable bowel syndrome (IBS). A literature resview was carried out on the following databases: PubMed, Embase, Cochrane, Cinahl, Scopus, PEDro and ClinicalTrials.gov. 350 articles were recovered. Eligibility criteria were evaluated by two independent reviewers, including randomized controlled trials (RCTs), quasi-RCTs, or ongoing RCTs with OMT compared to any kind of control in patients diagnosed with IBS. Six studies (five RCTs and one ongoing RCT) were considered eligible. Four RCTs were classified as some concerns and one as high risk of bias. In the meta-analysis, OMT compared to sham/no intervention showed statistically significant results for abdominal pain (effect size ES = -1.14 [-1.66, -0.62]; p < 0.0001) and constipation (ES = -0.66 [-1.12, -0.20]; p = 0.005). Instead, OMT was not superior to the control for the IBS symptoms measured with the IBS Severity Score and the Likert scale (ES = -0.34 [-0.83, 0.16]; p = 0.19), and diarrhea (ES = -1.20 [-2.84, 0.43]; p = 0.15). The quality of evidence was "low" for IBS symptoms in general for abdominal pain and constipation, while it was judged as "very low" for diarrhea. OMT turns out to be safe in the treatment of IBS without major adverse effects. OMT may be effective in IBS patients, however the results must be interpreted carefully due to the low methodological quality of the studies.
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Affiliation(s)
- Francesca Buffone
- Division of Paediatric, Manima Non-Profit Organization Social Assistance and Healthcare, 20125 Milan, Italy; (F.B.); (A.G.T.)
- Principles and Practice of Clinical Research (PPCR), Harvard T.H. Chan School of Public Health–ECPE, Boston, MA 02115, USA
| | - Andrea Gianmaria Tarantino
- Division of Paediatric, Manima Non-Profit Organization Social Assistance and Healthcare, 20125 Milan, Italy; (F.B.); (A.G.T.)
- Research Department, SOMA Istituto Osteopatia Milano, 20126 Milan, Italy; (F.B.); (A.S.); (G.B.); (A.B.)
| | - Federico Belloni
- Research Department, SOMA Istituto Osteopatia Milano, 20126 Milan, Italy; (F.B.); (A.S.); (G.B.); (A.B.)
| | - Andrea Spadafora
- Research Department, SOMA Istituto Osteopatia Milano, 20126 Milan, Italy; (F.B.); (A.S.); (G.B.); (A.B.)
- Intermediate Care Department, Caimi Hospital Foundation, 26019 Vailate, Italy
| | - Giorgio Bolzoni
- Research Department, SOMA Istituto Osteopatia Milano, 20126 Milan, Italy; (F.B.); (A.S.); (G.B.); (A.B.)
| | - Irene Bruini
- Division of Paediatric, Manima Non-Profit Organization Social Assistance and Healthcare, 20125 Milan, Italy; (F.B.); (A.G.T.)
- Research Department, SOMA Istituto Osteopatia Milano, 20126 Milan, Italy; (F.B.); (A.S.); (G.B.); (A.B.)
| | - Andrea Bergna
- Research Department, SOMA Istituto Osteopatia Milano, 20126 Milan, Italy; (F.B.); (A.S.); (G.B.); (A.B.)
| | - Luca Vismara
- Division of Neurology and Neurorehabilitation, IRCCS Istituto Auxologico Italiano, 28824 Piancavallo-Verbania, Italy;
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Vismara L, Gianmaria Tarantino A, Bergna A, Bianchi G, Bragalini C, Billò E, Dal Farra F, Buffone F, Agosti M. Correlation between diminished vagal tone and somatic dysfunction severity in very and extremely low birth weight preterm infants assessed with frequency spectrum heart rate variability and salivary cortisol. Medicine (Baltimore) 2022; 101:e30565. [PMID: 36197184 PMCID: PMC9509086 DOI: 10.1097/md.0000000000030565] [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] [Indexed: 11/25/2022] Open
Abstract
Osteopathic manipulative treatment (OMT) is evolving in the neonatal intensive care unit (NICU) setting. Studies showed its efficacy in length of stay and hospitalization costs reduction. Moreover, it was suggested that OMT has a modulatory effect on the preterm infants' autonomic nervous system (ANS), influencing saturation and heart rate. Even if OMT is based on the palpatory examination of the somatic dysfunctions (SD), there are controversies about its identification and clinical relevance. The objective of this study was to evaluate the inter-rater reliability, clinical characteristics, and functional correlation of the SD Grade score with the heart rate variability (HRV) and the salivary cortisol (sCor) using a multivariate linear model approach. To evaluate those features, we implemented an ad hoc SD examination for preterm infants that was performed by 2 trained osteopaths. It was based on the new variability model of SD that includes an SD Grade assessment procedure. The ANS features were assessed by frequency parameters of HRV studying high frequency (HF), low frequency (LF), and HF/LF, whereas sCor was tested with a radioimmunoassay. The ANS assessment was standardized and performed before SD testing. Sixty-nine premature infants were eligible. SD Grade showed excellent concordance between the blinded raters. Using SD Grade as a grouping variable, the infants presented differences in GA, Apgar, pathological findings, length of stay, and ventilatory assistance. In our multivariate model, HF, LF, and LF/HF resulted linearly correlated with SD Grade. Instead, sCor presented a linear correlation with 5' Apgar and respiratory distress syndrome but not with SD Grade. SD Grade was in line with the natural history of the underdevelopment due to prematurity. Our models indicate that the cardiac vagal tone is linearly related with SD Grade. This finding may improve the multidisciplinary decision making inside NICU and the management of modifiable factors, like SD, for cardiac vagal tone regulation.
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Affiliation(s)
- Luca Vismara
- Division of Neurology and Neurorehabilitation, IRCCS Istituto Auxologico Italiano, Piancavallo-Verbania, Italy
- Division of Paediatric, Manima Non-Profit Organization Social Assistance and Healthcare, Milan, Italy
- Department of Research, SOMA – Istituto Osteopatia Milano, Milan, Italy
- *Correspondence: Luca Vismara, Division of Neurology and Neurorehabilitation, IRCCS IstitutoAuxologico Italiano, Piancavallo-Verbania, Italy (e-mail: )
| | - Andrea Gianmaria Tarantino
- Department of Research, SOMA – Istituto Osteopatia Milano, Milan, Italy
- Woman and Child Department, Varese Hospital, Insubria University, via Ravasi 2 21100 Varese, Italy
| | - Andrea Bergna
- Woman and Child Department, Varese Hospital, Insubria University, via Ravasi 2 21100 Varese, Italy
| | - Giuliana Bianchi
- PPCR, Harvard T.H. Chan School of Public Health - ECPE, Boston, MA, USA
| | | | - Elisa Billò
- Department of Research, SOMA – Istituto Osteopatia Milano, Milan, Italy
| | - Fulvio Dal Farra
- Woman and Child Department, Varese Hospital, Insubria University, via Ravasi 2 21100 Varese, Italy
| | - Francesca Buffone
- Department of Research, SOMA – Istituto Osteopatia Milano, Milan, Italy
- Woman and Child Department, Varese Hospital, Insubria University, via Ravasi 2 21100 Varese, Italy
| | - Massimo Agosti
- PPCR, Harvard T.H. Chan School of Public Health - ECPE, Boston, MA, USA
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Dal Farra F, Buffone F, Risio RG, Tarantino AG, Vismara L, Bergna A. Effectiveness of osteopathic interventions in patients with non-specific neck pain: A systematic review and meta-analysis. Complement Ther Clin Pract 2022; 49:101655. [PMID: 35986986 DOI: 10.1016/j.ctcp.2022.101655] [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] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Revised: 07/13/2022] [Accepted: 08/01/2022] [Indexed: 11/15/2022]
Abstract
OBJECTIVE The aim of this systematic review and meta-analysis is to evaluate whether osteopathic manipulative interventions can reduce pain levels and enhance the functional status in patients with non-specific neck pain (NS-NP). METHODS A systematic review and meta-analysis was conducted following the 2020 PRISMA statement. Randomized controlled trials (RCTs) were searched in five databases, assessed through a standardized form, and evaluated using the "13 items Cochrane risk of bias (RoB) tool". Effect sizes (ES) were calculated post-treatment, and the quality of evidence was assessed through GRADE criteria. RESULTS Five articles were included in the review, and none of these was completely judged at low RoB. Four of these were included in the meta-analysis. Osteopathic interventions compared to no intervention/sham treatment showed statistically significant results for pain levels (ES = -1.57 [-2.50, -0.65]; P = 0.0008) and functional status (ES = -1.71 [-3.12, -0.31]; P = 0.02). The quality of evidence was "very low" for all the assessed outcomes. Other results were presented in a qualitative synthesis. CONCLUSIONS Osteopathic interventions could be effective for pain levels and functional status improvements in adults with NS-NP. However, these findings are affected by a very low quality of evidence. Therefore, further high-quality RCTs are necessary to improve the quality of evidence and generalize the results.
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Affiliation(s)
- Fulvio Dal Farra
- Department of Research, SOMA - Istituto Osteopatia Milano, Milan, Italy; Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy.
| | - Francesca Buffone
- Department of Research, SOMA - Istituto Osteopatia Milano, Milan, Italy; Division of Paediatric, Manima Non-Profit Organization Social Assistance and Healthcare, Milan, Italy; PPCR, Harvard T.H. Chan School of Public Health - ECPE, Boston, USA.
| | | | - Andrea Gianmaria Tarantino
- Department of Research, SOMA - Istituto Osteopatia Milano, Milan, Italy; Division of Paediatric, Manima Non-Profit Organization Social Assistance and Healthcare, Milan, Italy.
| | - Luca Vismara
- Department of Research, SOMA - Istituto Osteopatia Milano, Milan, Italy; Division of Paediatric, Manima Non-Profit Organization Social Assistance and Healthcare, Milan, Italy; Division of Neurology and Neurorehabilitation, IRCCS Istituto Auxologico Italiano, Piancavallo-Verbania, Italy; Department of Neurosciences "Rita Levi Montalcini", University of Turin, 10126, Turin, Italy.
| | - Andrea Bergna
- Department of Research, SOMA - Istituto Osteopatia Milano, Milan, Italy.
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