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Cioeta M, Youssef S, Brindisino F, Venturin D, Pichero R, Giovannico G, Pournajaf S, Goffredo M, Caselli S, Pellicciari L. Cross-cultural adaptation and psychometric properties of the Italian version of the Patient-Specific Functional Scale (PSFS) in subjects with shoulder pain. Disabil Rehabil 2024:1-7. [PMID: 38700257 DOI: 10.1080/09638288.2024.2342495] [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: 06/20/2023] [Accepted: 04/09/2024] [Indexed: 05/05/2024]
Abstract
PURPOSE To cross-culturally adapt the Patient-Specific Functional Scale (PSFS) into Italian and study its classic psychometric properties in subjects with shoulder pain (SP). MATERIALS AND METHODS The PSFS was translated into Italian and administered to 109 SP subjects. Acceptability (time to administer, floor and ceiling effects), reliability (internal consistency [Cronbach's alpha], test-retest reliability [Intraclass Correlation Coefficient (ICC)], and measurement error [Standard Error of Measurement (SEM), Minimal Detectable Change, (MDC)]), were assessed. Moreover, construct validity was investigated through a-priori hypothesis testing, comparing the PSFS with the Disability of the Shoulder, Arm and Hand (DASH) scale, 36-item Short Form Health Survey (SF-36) and Numeric Pain Rating scale (NPRS). RESULTS The PSFS was successfully adapted into Italian, and its acceptability was satisfied. Internal consistency was high (Cronbach's alpha = 0.925), and test-retest reliability was good (ICC = 0.866, 95% CI = 0.749-0.931). A SEM of 0.7 points and an MDC of 1.9 points were obtained. We observed moderate evidence for construct validity, with 4/6 correlations between other measures being respected. CONCLUSION This study provided reliability and validity of the PSFS in a sample of Italian SP subjects. Future studies should assess the responsiveness of using the PSFS as an outcome measure to capture clinical changes after treatment.
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Affiliation(s)
- Matteo Cioeta
- Research Area in Neuromotor Rehabilitation and Rehabilitation Robotics, Department of Neurological and Rehabilitation Sciences, IRCCS San Raffaele Roma, Rome, Italy
| | - Saad Youssef
- Department of Medicine and Health Science "Vincenzo Tiberio", University of Molise, Campobasso, Italy
| | - Fabrizio Brindisino
- Department of Medicine and Health Science "Vincenzo Tiberio", University of Molise, Campobasso, Italy
| | - Davide Venturin
- Department of Medicine and Health Science "Vincenzo Tiberio", University of Molise, Campobasso, Italy
- Kinè Physiotherapic and Orthopedic Center, San Vendemiano, Treviso, Italy
| | - Roberto Pichero
- Department of Medicine and Health Science "Vincenzo Tiberio", University of Molise, Campobasso, Italy
| | - Giuseppe Giovannico
- Department of Medicine and Health Science "Vincenzo Tiberio", University of Molise, Campobasso, Italy
| | - Sanaz Pournajaf
- Research Area in Neuromotor Rehabilitation and Rehabilitation Robotics, Department of Neurological and Rehabilitation Sciences, IRCCS San Raffaele Roma, Rome, Italy
| | - Michela Goffredo
- Research Area in Neuromotor Rehabilitation and Rehabilitation Robotics, Department of Neurological and Rehabilitation Sciences, IRCCS San Raffaele Roma, Rome, Italy
- Department of Human Sciences and Promotion of the Quality of Life, San Raffaele University, Rome, Italy
| | - Serena Caselli
- Azienda Ospedaliero-Universitaria di Modena, Modena, Italy
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Esposto M, Pellicciari L, Cecchetto S, Chiarotto A, Testa M, Turolla A, Polli A. Italian versions of the Neurophysiology of Pain Questionnaire (NPQ): psychometric properties and an investigation on the understanding of pain neurophysiology in physical therapists. Musculoskelet Sci Pract 2024; 72:102957. [PMID: 38642475 DOI: 10.1016/j.msksp.2024.102957] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2023] [Revised: 02/29/2024] [Accepted: 04/09/2024] [Indexed: 04/22/2024]
Abstract
OBJECTIVES The Neurophysiology of Pain Questionnaire (NPQ) is widely used to assess pain knowledge among clinicians and patients with pain, but an Italian version is not available. This study aimed to translate and cross-culturally adapt the NPQ into Italian, to test its psychometric properties, to assess the knowledge of Italian physical therapists (PTs) on pain, and to evaluate which characteristics are associated with pain knowledge. METHODS The NPQ was translated into Italian, integrated with some additional questions (IT-NPQ-New), and sent by email via the Italian Association of Physiotherapy newsletter. Rasch analysis (RA) was used to test the psychometric properties of the Italian versions. Multivariable regression analyses were used to check for associations between participants' characteristics and their NPQ scores. RESULTS A sample of 753 PTs completed the survey. RA of the NPQ-19 and IT-NPQ-New revealed that 10 (IT-NPQ-10) and 18 (IT-NPQ-18) items fit the model. Both questionnaires showed good psychometric properties. The overall median score among Italian PTs was 6.0 [5.0-7.0] and 11.0 [9.0-13.0] points for the IT-NPQ-10 and the IT-NPQ-18, respectively. These scores were statistically different among groups according to gender, age, years of professional activity, post-graduate specialization and days attended of targeted pain courses, with the latter being the most influential variable. CONCLUSIONS Italian PTs now dispose of two tools to assess their basic knowledge related to pain science. Our study also showed that pain knowledge among Italian PTs needs improvement, especially considering recent biopsychosocial approaches to pain.
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Affiliation(s)
- Massimo Esposto
- Department of Medicine and Health Science "Vincenzo Tiberio", University of Molise, C/o Cardarelli Hospital, C/da Tappino, 86100, Campobasso, Italy
| | | | - Simone Cecchetto
- Health Professional and Rehabilitation Service APSS Trento, Trento, Italy
| | - Alessandro Chiarotto
- Department of General Practice, Erasmus MC, University Medical Center, Rotterdam, the Netherlands
| | - Marco Testa
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genova, Genova, Italy
| | - Andrea Turolla
- Department of Biomedical and Neuromotor Sciences, Alma Mater Studiorum University of Bologna, Bologna, Italy; Unit of Occupational Medicine, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Andrea Polli
- Pain in Motion Research Group, Department of Physiotherapy, Human Physiology, and Anatomy, Vrije Universiteit Brussel (VUB), Centre for Environment & Health, Department of Public Health and Primary Care, Katholieke Universiteit Leuven (KUL), Research Foundation - Flanders (FWO), Belgium
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Giovannico G, Pappaccogli M, Cioeta M, Pellicciari L, Youssef S, Angilecchia D, Giannotta G, Brindisino F. The Musculoskeletal 30-question multiple choice questionnaire (MSK-30): a new assessing tool of musculoskeletal competence in a sample of Italian physiotherapists. BMC Musculoskelet Disord 2024; 25:265. [PMID: 38575894 PMCID: PMC10996259 DOI: 10.1186/s12891-024-07400-6] [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] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Accepted: 03/30/2024] [Indexed: 04/06/2024] Open
Abstract
BACKGROUND The prevalence and cost of musculoskeletal diseases increased dramatically over the past few decades. Therefore, several institutions have begun to re-evaluate the quality of their musculoskeletal educational paths. However, current standardized questionnaires inadequately assess musculoskeletal knowledge, and other musculoskeletal-specific exams have limitations in implementation. The musculoskeletal 30-question multiple choice questionnaire (MSK-30) was proposed as a new tool for assessing basic musculoskeletal knowledge. AIM To analyse basic musculoskeletal knowledge in a sample of Italian physiotherapists by administering the MSK-30 questionnaire. METHODS After a transcultural adaptation process, the MSK-30 was developed and administered to Italian physiotherapists to assess their musculoskeletal knowledge. Participants were invited to participate in the survey via the SurveyMonkey link. Mann-Whitney test and the Kruskal-Wallis test with Bonferroni correction were used to observe the differences between groups in the MSK-30 scores. RESULTS Four hundred-fourteen (n=414) physiotherapists participated in the survey. The median MSK-30 value was higher in physiotherapists who attended the International Federation of Orthopaedic Manipulative Physical Therapists postgraduate certification than in those who attended unstructured postgraduate training in musculoskeletal condition or in those who had not completed any postgraduate training in this field (p<0.001). CONCLUSIONS This work demonstrates significant differences in the management of musculoskeletal disorders between those with specific postgraduate university education and those without. The findings can contribute to the advancement of the physiotherapy profession in Italy. Authors recommend further research with more robust methodologies to deeper understand this topic. Musculoskeletal conditions will continue to represent a significant portion of primary care visits, and future generations of physiotherapists must be prepared to address this challenge.
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Affiliation(s)
- Giuseppe Giovannico
- Department of Medicine and Health Science Vincenzo Tiberio, University of Molise c/o Cardarelli Hospital, C/da Tappino, 86100, Campobasso, Italy
| | - Marco Pappaccogli
- Department of Medicine and Health Science Vincenzo Tiberio, University of Molise c/o Cardarelli Hospital, C/da Tappino, 86100, Campobasso, Italy
| | | | | | - Saad Youssef
- Department of Medicine and Health Science Vincenzo Tiberio, University of Molise c/o Cardarelli Hospital, C/da Tappino, 86100, Campobasso, Italy
| | - Domenico Angilecchia
- Department of Medicine and Health Science Vincenzo Tiberio, University of Molise c/o Cardarelli Hospital, C/da Tappino, 86100, Campobasso, Italy
- Rehabilitation service - ASL Bari, Bari, Italy
| | - Gabriele Giannotta
- Scientific Institute IRCCS "E. Medea" - Unit for Severe disabilities in developmental age and young adults Developmental Neurology and Neurorehabilitation, Brindisi, Italy
| | - Fabrizio Brindisino
- Department of Medicine and Health Science Vincenzo Tiberio, University of Molise c/o Cardarelli Hospital, C/da Tappino, 86100, Campobasso, Italy
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Brindisino F, Venturin D, Bartoli M, Caselli S, Pellicciari L, Poser A. Psychometric properties of the Disability of Arm Shoulder and Hand (DASH) in subjects with frozen shoulder: a reliability and validity study. BMC Musculoskelet Disord 2024; 25:260. [PMID: 38566086 PMCID: PMC10986124 DOI: 10.1186/s12891-024-07371-8] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Accepted: 03/20/2024] [Indexed: 04/04/2024] Open
Abstract
BACKGROUND Frozen Shoulder (FS) is a painful condition characterized by severe pain and progressive restriction of shoulder movement, leading to functional impairment and reduced quality of life. While different Patient Reported Outcome Measurements (PROMs) tools exist for assessing shoulder diseases, few specific PROMs are validated for FS patients. PURPOSE This study aims to assess the psychometric properties of the Disability of Arm, Shoulder, and Hand (DASH) questionnaire in FS patients. METHODS One hundred and twenty-four subjects (mean ± SD age = 55.4 ± 7.9 years; 55.6% female) diagnosed with FS were included and completed the DASH questionnaire, the Numerical Pain Rating Scale (NPRS), the Shoulder Pain and Disability Index (SPADI), and the Short-Form Health Survey 36 (SF-36). Floor or ceiling effects were investigated. Structural validity was analysed through a unidimensional Confirmatory Factor Analysis (CFA), internal consistency through Cronbach's alpha, test-retest reliability through the Intraclass Correlation coefficient (ICC), measurement error through the Standard Error of Measurement (SEM), and the Minimum Detectable Change (MDC), and construct validity through the hypothesis testing with the correlation with the other outcome measures used. RESULTS No floor or ceiling effects were observed. CFA confirmed a one-factor structure after addressing local item dependency (Root Mean Square Error of Approximation = 0.055; Standardized Root Mean Square Residual = 0.077; Comparative Fit Index = 0.970; Tucker-Lewis Index = 0.968). Cronbach's alpha was high (= 0.951), and test-retest reliability was excellent (ICC = 0.999; 95% CI: 0.998-1.000). SEM was equal to 0.5 points, and MDC to 1.5 points. Construct validity was considered satisfactory as 80% of the a-priori hypotheses were met. CONCLUSION The DASH questionnaire demonstrated good psychometric properties in FS patients, supporting its use as a valuable tool for assessing the impact of FS in clinical and research settings.
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Affiliation(s)
- Fabrizio Brindisino
- Department of Medicine and Health Science "Vincenzo Tiberio", University of Molise c/o Cardarelli Hospital, C/da Tappino, Campobasso, 86100, Italy
| | - Davide Venturin
- Department of Medicine and Health Science "Vincenzo Tiberio", University of Molise c/o Cardarelli Hospital, C/da Tappino, Campobasso, 86100, Italy
| | - Matteo Bartoli
- Physiotherapy private practice KinesiLab, via Marcantonio Colonna 88, Marino, Italy
| | - Serena Caselli
- Unità Operativa di Medicina Riabilitativa, Azienda Ospedaliero-Universitaria di Modena, Modena, Italy
| | - Leonardo Pellicciari
- IRCCS Istituto delle Scienze Neurologiche di Bologna, Via Altura, 3, Bologna, I-40139, Italy.
| | - Antonio Poser
- Physiotherapy private practice Kinè, Kinè s.r.l, Viale della Quercia 2/B,, Treviso, Italy
- University of Siena, c/o via Banchi di Sotto, 55, Siena, Italy
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Gianola S, Bargeri S, Pellicciari L, Gambazza S, Rossettini G, Fulvio A, Genovese V, Benedini M, Proverbio E, Cecchetto S, Castellini G, Turolla A. Evidence-informed and consensus-based statements about SAFEty of Physical Agent Modalities Practice in physiotherapy and rehabilitation medicine (SAFE PAMP): a national Delphi of healthcare scientific societies. BMJ Open 2024; 14:e075348. [PMID: 38508626 PMCID: PMC10953005 DOI: 10.1136/bmjopen-2023-075348] [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] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Accepted: 03/05/2024] [Indexed: 03/22/2024] Open
Abstract
OBJECTIVE A shared consensus on the safety about physical agent modalities (PAMs) practice in physiotherapy and rehabilitation is lacking. We aimed to develop evidence-informed and consensus-based statements about the safety of PAMs. STUDY DESIGN AND SETTING A RAND-modified Delphi Rounds' survey was used to reach a consensus. We established a steering committee of the Italian Association of Physiotherapy (Associazione Italiana di Fisioterapia) to identify areas and questions for developing statements about the safety of the most commonly used PAMs in physiotherapy and rehabilitation. We invited 28 National Scientific and Technical Societies, including forensics and lay members, as a multidisciplinary and multiprofessional panel of experts to evaluate the nine proposed statements and formulate additional inputs. The level of agreement was measured using a 9-point Likert scale, with consensus in the Delphi Rounds assessed using the rating proportion with a threshold of 75%. RESULTS Overall, 17 (61%) out of 28 scientific and technical societies participated, involving their most representative members. The panel of experts mainly consisted of clinicians (88%) with expertise in musculoskeletal (47%), pelvic floor (24%), neurological (18%) and lymphatic (6%) disorders with a median experience of 30 years (IQR=17-36). Two Delphi rounds were necessary to reach a consensus. The final approved criteria list comprised nine statements about the safety of nine PAMs (ie, electrical stimulation neuromodulation, extracorporeal shock wave therapy, laser therapy, electromagnetic therapy, diathermy, hot thermal agents, cryotherapy and therapeutic ultrasound) in adult patients with a general note about populations subgroups. CONCLUSIONS The resulting consensus-based statements inform patients, healthcare professionals and policy-makers regarding the safe application of PAMs in physiotherapy and rehabilitation practice. Future research is needed to extend this consensus on paediatric and frail populations, such as immunocompromised patients.
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Affiliation(s)
- Silvia Gianola
- Unit of Clinical Epidemiology, IRCCS Istituto Ortopedico Galeazzi, Milano, Italy
| | - Silvia Bargeri
- Unit of Clinical Epidemiology, IRCCS Istituto Ortopedico Galeazzi, Milano, Italy
| | | | - Simone Gambazza
- Healthcare Professions Department, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Giacomo Rossettini
- School of Physiotherapy, Università degli Studi di Verona, Verona, Italy
- Department of Human Neurosciences, University of Roma "Sapienza Roma", Rome, Italy
- Department of Physiotherapy, Faculty of Sport Sciences, Universidad Europea de Madrid, Calle Tajo s/n, Villaviciosa de Odón 28670, Spain
| | - Anna Fulvio
- Associazione Italiana di Fisioterapia, Rome, Italy
| | | | | | | | - Simone Cecchetto
- Associazione Italiana di Fisioterapia, Rome, Italy
- Direction of Health Professions, APSS, 38014, Trento, Italy
| | - Greta Castellini
- Unit of Clinical Epidemiology, IRCCS Istituto Ortopedico Galeazzi, Milano, Italy
| | - Andrea Turolla
- Department of Biomedical and Neuromotor Sciences-DIBINEM, Alma Mater Studiorum Università di Bologna, Bologna, Italy
- Unit of Occupational Medicine, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
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Galardini L, Coppari A, Pellicciari L, Ugolini A, Piscitelli D, La Porta F, Bravini E, Vercelli S. Minimal Clinically Important Difference of the Disabilities of the Arm, Shoulder and Hand (DASH) and the Shortened Version of the DASH (QuickDASH) in People with Musculoskeletal Disorders: A Systematic Review and Meta-Analysis. Phys Ther 2024:pzae033. [PMID: 38438144 DOI: 10.1093/ptj/pzae033] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Revised: 10/30/2023] [Accepted: 02/22/2024] [Indexed: 03/06/2024]
Abstract
OBJECTIVE The objective of this study was to perform a meta-analysis of the minimal clinically important difference (MCID) of the Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire and its shortened version (ie, the QuickDASH). METHODS MEDLINE, EMBASE, CINAHL, PsycINFO, Web of Science, Cochrane Library, and Scopus were searched up to July 2022. Studies on people with upper limb musculoskeletal disorders that calculated the MCID by anchor-based methods were included. Descriptive and quantitative synthesis was used for the MCID and the minimal detectable change with 90% confidence (MDC90). Fixed-effects models and random-effect models were used for the meta-analysis. I2 statistics was computed to assess heterogeneity. The methodological quality of studies was assessed with the Consensus-Based Standards for the Selection of Health Measurement Instruments checklist for measurement error and an adaptation of the checklist for the MCID proposed by Bohannon & Glenney. RESULTS Twelve studies (1677 patients) were included, producing 17 MCID estimates ranging from 8.3 to 18.0 DASH points and 8.0 to 18.1 QuickDASH points. The pooled MCIDs were 11.00 DASH points (95% CI = 8.59 to 13.41; I2 = 0%) and 11.97 QuickDASH points (95% CI = 9.60 to 14.33; I2 = 0%). The pooled MDC90s were 9.04 DASH points (95% CI = 6.46 to 11.62; I2 = 0%) and 9.03 QuickDASH points (95% CI = 6.36 to 11.71; I2 = 18%). Great heterogeneity was identified among the primary studies along with important methodological problems in the calculation of the MCID. CONCLUSION Reasonable MCID ranges of 12 to 14 DASH points and 12 to 15 QuickDASH points were established. The lower boundaries represent the first available measure above the pooled MDC90, and the upper limits represent the upper 95% CI of the pooled MCID. IMPACT Reasonable ranges for the MCID of 12 to 14 DASH points and 12 to 15 QuickDASH points were proposed. The lower boundaries represent the first available measure above the pooled MDC90, and the upper limits represent the upper 95% CI of the pooled MCID. Information regarding the interpretability of the 2 questionnaires was derived from very different methodologies, making it difficult to identify reliable thresholds. Now clinicians and researchers can rely on more credible data. The MCID proposed should be used to assess people with musculoskeletal disorders. Heterogeneity was found related particularly to the anchor levels used in the primary studies. To promote comparability of MCID values, shared rules defining the most appropriate types of anchoring will be needed in the near future.
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Affiliation(s)
- Lorenzo Galardini
- Department of Human Neurosciences, Sapienza University of Roma, Rome, Italy
| | - Andrea Coppari
- Physical and Rehabilitation Medicine Unit, Azienda Sanitaria Territoriale, Jesi (AN), Italy
| | | | | | | | - Fabio La Porta
- IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy
| | | | - Stefano Vercelli
- Rehabilitation Research Laboratory 2rLab, Department of Business Economics, Health and Social Care, University of Applied Sciences and Arts of Southern Switzerland, Manno, Switzerland
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Pellicciari L, Basagni B, Paperini A, Campagnini S, Sodero A, Hakiki B, Castagnoli C, Politi AM, Avila L, Barilli M, Romano E, Pancani S, Mannini A, Sensoli F, Salvadori E, Poggesi A, Grippo A, Macchi C, Baccini M, Carrozza MC, Cecchi F. Trunk Control Test as a Main Predictor of the Modified Barthel Index Score at Discharge From Intensive Post-acute Stroke Rehabilitation: Results From a Multicenter Italian Study. Arch Phys Med Rehabil 2024; 105:326-334. [PMID: 37625531 DOI: 10.1016/j.apmr.2023.08.007] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Revised: 07/05/2023] [Accepted: 08/06/2023] [Indexed: 08/27/2023]
Abstract
OBJECTIVES To verify whether trunk control test (TCT) upon admission to intensive inpatient post-stroke rehabilitation, combined with other confounding variables, is independently associated with discharge mBI. DESIGN Multicentric retrospective observational cohort study. SETTING Two Italian inpatient rehabilitation units. PARTICIPANTS A total of 220 post-stroke adult patients, within 30 days from the acute event, were consecutively enrolled. INTERVENTIONS Not applicable. MAIN OUTCOME MEASURE The outcome measure considered was the modified Barthel Index (mBI), one of the most widely recommended tools for assessing stroke rehabilitation functional outcomes. RESULTS All variables collected at admission and significantly associated with mBI at discharge in the univariate analysis (TCT, mBI at admission, pre-stroke modified Rankin Scale [mRS], sex, age, communication ability, time from the event, Cumulative Illness Rating Scale, bladder catheter, and pressure ulcers) entered the multivariate analysis. TCT, mBI at admission, premorbid disability (mRS), communication ability and pressure ulcers (P<.001) independently predicted discharge mBI (adjusted R2=68.5%). Concerning the role of TCT, the model with all covariates and without TCT presented an R2 of 65.1%. On the other side, the model with the TCT only presented an R2 of 53.1%. Finally, with the inclusion of both TCT and all covariates, the model showed an R2 increase up to 68.5%. CONCLUSIONS TCT, with other features suggesting functional/clinical complexity, collected upon admission to post-acute intensive inpatient stroke rehabilitation, independently predicted discharge mBI.
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Affiliation(s)
| | | | - Anita Paperini
- IRCCS Fondazione Don Carlo Gnocchi onlus, Firenze, Italy
| | - Silvia Campagnini
- IRCCS Fondazione Don Carlo Gnocchi onlus, Firenze, Italy; The Biorobotics Institute, Scuola Superiore Sant'Anna, Pontedera (Pisa), Italy.
| | - Alessandro Sodero
- IRCCS Fondazione Don Carlo Gnocchi onlus, Firenze, Italy; Neurofarba Department, Neuroscience Section, University of Florence, Firenze, Italy
| | - Bahia Hakiki
- IRCCS Fondazione Don Carlo Gnocchi onlus, Firenze, Italy
| | | | | | - Lucia Avila
- Fondazione Don Carlo Gnocchi onlus, Marina di Massa, Italy
| | | | | | - Silvia Pancani
- IRCCS Fondazione Don Carlo Gnocchi onlus, Firenze, Italy
| | - Andrea Mannini
- IRCCS Fondazione Don Carlo Gnocchi onlus, Firenze, Italy
| | - Federico Sensoli
- The Biorobotics Institute, Scuola Superiore Sant'Anna, Pontedera (Pisa), Italy
| | | | - Anna Poggesi
- IRCCS Fondazione Don Carlo Gnocchi onlus, Firenze, Italy; Neurofarba Department, Neuroscience Section, University of Florence, Firenze, Italy
| | - Antonello Grippo
- IRCCS Fondazione Don Carlo Gnocchi onlus, Firenze, Italy; SOD Neurofisiopatologia, Dipartimento Neuromuscolo-Scheletrico e degli Organi di Senso, Azienda Ospedaliera Universitaria Careggi, Firenze, Italy
| | - Claudio Macchi
- IRCCS Fondazione Don Carlo Gnocchi onlus, Firenze, Italy; Department of Experimental and Clinical Medicine, University of Florence, Firenze, Italy
| | - Marco Baccini
- IRCCS Fondazione Don Carlo Gnocchi onlus, Firenze, Italy
| | | | - Francesca Cecchi
- IRCCS Fondazione Don Carlo Gnocchi onlus, Firenze, Italy; Department of Experimental and Clinical Medicine, University of Florence, Firenze, Italy
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Pagliari C, Di Tella S, Jonsdottir J, Mendozzi L, Rovaris M, De Icco R, Milanesi T, Federico S, Agostini M, Goffredo M, Pellicciari L, Franceschini M, Cimino V, Bramanti P, Baglio F. Effects of home-based virtual reality telerehabilitation system in people with multiple sclerosis: A randomized controlled trial. J Telemed Telecare 2024; 30:344-355. [PMID: 34851211 DOI: 10.1177/1357633x211054839] [Citation(s) in RCA: 14] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
BACKGROUND AND OBJECTIVE Multiple sclerosis is an inflammatory and neurodegenerative disorder of the central nervous system that can lead to severe motor disability. The aim of this study was to verify the health care effects of an integrated telerehabilitation approach involving dual-domains (motor and cognitive) in people with multiple sclerosis using a virtual reality rehabilitation system compared to a home-based conventional rehabilitative intervention usual care for patient-relevant outcomes (motor, cognitive and participation). METHODS This multicentre interventional, randomized controlled trial included 70 participants with multiple sclerosis, 35 in the telerehabilitation group (30 sessions of home-based virtual reality rehabilitation system training, five sessions for week each lasting 45 min) and 35 in the usual care group (30 sessions of conventional treatment, five sessions for week). Participants completed the assessment of motor, cognitive and participation outcomes at baseline and after 6 weeks of treatment. RESULTS In total, 63.3% of the telerehabilitation group exhibited improvement in the physical domain of the quality of life (p = 0.045). The telerehabilitation group showed greater improvement than the usual care group in Mini-BESTest domains of balance (p = 0.014), postural control (p = 0.024), and dynamic walking (p = 0.020) at post-treatment. Higher adherence was registered for telerehabilitation compared with usual care (86.67% vs. 80.0%). DISCUSSION This study provides evidence that people with multiple sclerosis can benefit from telerehabilitation treatment in the physical domain of the quality of life and motor symptoms. Moreover, considering the persistent COVID-19 emergency, telerehabilitation can represent an effective telemedicine solution for safely delivering effective rehabilitation care to people with multiple sclerosis. TRIAL REGISTRATION NUMBER AND TRIAL REGISTER This trial was registered at ClinicalTrials.gov (NCT03444454).
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Affiliation(s)
| | - Sonia Di Tella
- IRCCS Fondazione Don Carlo Gnocchi ONLUS, Milan, Italy
- Department of Psychology, Università Cattolica del Sacro Cuore, Italy
| | | | | | - Marco Rovaris
- IRCCS Fondazione Don Carlo Gnocchi ONLUS, Milan, Italy
| | - Roberto De Icco
- Headache Science & Neurorehabilitation Center, IRCCS Mondino Foundation, Pavia, Italy
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Tommaso Milanesi
- Headache Science & Neurorehabilitation Center, IRCCS Mondino Foundation, Pavia, Italy
| | | | - Michela Agostini
- Department of Neuroscience, Section of Rehabilitation, University-General Hospital of Padova, Italy
| | - Michela Goffredo
- Neurorehabilitation Research Laboratory, Department of Neurological and Rehabilitation Sciences, IRCCS San Raffaele Roma, Rome, Italy
| | - Leonardo Pellicciari
- Neurorehabilitation Research Laboratory, Department of Neurological and Rehabilitation Sciences, IRCCS San Raffaele Roma, Rome, Italy
| | - Marco Franceschini
- Neurorehabilitation Research Laboratory, Department of Neurological and Rehabilitation Sciences, IRCCS San Raffaele Roma, Rome, Italy
- Department of Human Sciences and Promotion of the Quality of Life, San Raffaele University, Rome, Italy
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9
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Piscitelli D, Brichetto G, Geri T, Battista S, Testa M, Monti Bragadin M, Pellicciari L. Italian adaptation and psychometric validation of the Fatigue Impact Scale (FIS) and its modified versions in adults with multiple sclerosis: a Rasch analysis study. Disabil Rehabil 2024:1-14. [PMID: 38236054 DOI: 10.1080/09638288.2024.2302878] [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: 05/25/2023] [Accepted: 12/21/2023] [Indexed: 01/19/2024]
Abstract
Purpose: Several outcome measures are available to assess the severity of fatigue in people with multiple sclerosis (MS). The aim of this study was to adapt the Italian version of the Fatigue Impact Scale (FIS-40) and its modified versions: a 21-item Modified scale (MFIS-21), its 5-item short version (MFIS-5), and an 8-item version for daily use (DFIS-8) and investigate their measurement properties through classical theory-test (CTT) and Rasch analysis (RA).Methods: 229 Italian-speaking adults with MS were included. Questionnaires were cross-culturally translated and subjected to CTT (i.e. internal consistency through Cronbach's alpha and unidimensionality through confirmatory factor analysis [CFA]) and RA. (i.e. internal construct validity, reliability, and targeting).Results: Internal consistency was high for all scales (>0.850). Final CFAs reported issues in the unidimensionality for all scales except for FIS-40. Baseline RA revealed a misfit for all scales. After adjusting for local dependency, FIS-40, MFIS-21, and MFIS-5 fitted the Rasch model (RM). MFIS-21 and D-FIS-8 required a structural modification, i.e. item deletions to satisfy the RM.Conclusion: The FIS-40, MFIS-21, MFIS-5, and DFIS-8 achieved the fit to the RM after statistical and structural modifications. The fit to the RM allowed for providing ordinal-to-interval measurement conversion tables for all the questionnaires.
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Affiliation(s)
- Daniele Piscitelli
- Doctor of Physical Therapy Program, Department of Kinesiology, University of Connecticut, Storrs, CT, USA
- School of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy
| | - Giampaolo Brichetto
- Scientific Research Area, Italian MS Foundation (FISM), Genoa, Italy
- AISM Rehabilitation Center, Italian MS Society (AISM), Genoa, Italy
| | | | - Simone Battista
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa, Campus of Savona, Italy
| | - Marco Testa
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa, Campus of Savona, Italy
| | - Margherita Monti Bragadin
- Scientific Research Area, Italian MS Foundation (FISM), Genoa, Italy
- AISM Rehabilitation Center, Italian MS Society (AISM), Genoa, Italy
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10
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Stano F, Pellicciari L, La Porta F, Piscitelli D, Angilecchia D, Signorelli M, Giovannico G, Pournajaf S, Caselli S. Rasch analysis of the forgotten joint score in patients with total hip arthroplasty. J Rehabil Med 2024; 56:jrm15774. [PMID: 38197243 PMCID: PMC10795689 DOI: 10.2340/jrm.v56.15774] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Accepted: 11/14/2023] [Indexed: 01/11/2024] Open
Abstract
OBJECTIVE To assess the internal construct validity, including local independence, unidimensionality, monotonicity, and invariance, reliability, and targeting of the Forgotten Joint Score within the Rasch Measurement Theory framework. DESIGN Cross-sectional study. PATIENTS A total of 111 patients with total hip arthroplasty at least 3 months after surgery. METHODS The Forgotten Joint Score was submitted to each subject during their rehabilitative treatment in an Italian centre and then to Rasch analysis. RESULTS The base Rasch analysis showed a satisfactory fit to the model with strict unidimensionality and no differential item functioning. However, monotonicity (11 out of 12 items showed disordered thresholds) and local independence were violated. After rescoring 10 items and creating 5 subtests to account for local dependence, the scale satisfied all the other Rasch model requirements (i.e. invariance, local independence, monotonicity, unidimensionality, and multi-group invariance), with reliability indexes (> 0.850) for measurement at the individual level and proper targeting. A raw-score-to-measure conversion table was provided. CONCLUSION After structural (i.e. collapsing items categories) and non-structural (i.e. creating subtests) strategies, the Forgotten Joint Score satisfied the measurement requirements of the Rasch model, and it can be used in patients with total hip arthroplasty in clinical and research settings.
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Affiliation(s)
- Flavia Stano
- Department of Medicine and Health Science "Vincenzo Tiberio", University of Molise, Campobasso, Italy
| | | | - Fabio La Porta
- IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy
| | | | - Domenico Angilecchia
- Department of Medicine and Health Science "Vincenzo Tiberio", University of Molise, Campobasso, Italy; Rehabilitation service - ASL, Bari, Italy
| | | | - Giuseppe Giovannico
- Department of Medicine and Health Scienze "Vincenzo Tiberio", University of Molise, Campobasso, Italy
| | - Sanaz Pournajaf
- Neurorehabilitation Research Lab, Department of Neurological and Rehabilitation Sciences, IRCCS San Raffaele, Rome, Italy
| | - Serena Caselli
- Unità Operativa Complessa di Medicina Riabilitativa, Azienda Ospedaliero-Universitaria di Modena, Modena, Italy
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11
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Basagni B, Malloggi S, Polito C, Pellicciari L, Campagnini S, Pancani S, Mannini A, Gemignani P, Salvadori E, Marignani S, Giovannelli F, Viggiano MP, Hakiki B, Grippo A, Macchi C, Cecchi F. MoCA Domain-Specific Pattern of Cognitive Impairment in Stroke Patients Attending Intensive Inpatient Rehabilitation: A Prospective Study. Behav Sci (Basel) 2024; 14:42. [PMID: 38247694 PMCID: PMC10813017 DOI: 10.3390/bs14010042] [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: 10/31/2023] [Revised: 12/18/2023] [Accepted: 12/24/2023] [Indexed: 01/23/2024] Open
Abstract
A domain-specific perspective to cognitive functioning in stroke patients may predict their cognitive recovery over time and target stroke rehabilitation intervention. However, data about domain-specific cognitive impairment after stroke are still scarce. This study prospectively investigated the domain-specific pattern of cognitive impairments, using the classification proposed by the Montreal Cognitive Assessment (MoCA), in a cohort of 49 stroke patients at admission (T0), discharge (T1), and six-month follow-up (T2) from subacute intensive rehabilitation. The predictive value of T0 cognitive domains cognitive impairment at T1 and T2 was also investigated. Patients' cognitive functioning at T0, T1, and T2 was assessed through the MoCA domains for executive functioning, attention, language, visuospatial, orientation, and memory. Different evolutionary trends of cognitive domain impairments emerged across time-points. Patients' impairments in all domains decreased from T0 to T1. Attention and executive impairments decreased from T0 to T2 (42.9% and 26.5% to 10.2% and 18.4%, respectively). Conversely, altered visuospatial, language, and orientation increased between T1 and T2 (16.3%, 36.7%, and 40.8%, respectively). Additionally, patients' global cognitive functioning at T1 was predicted by the language and executive domains in a subacute phase (p = 0.031 and p = 0.001, respectively), while in the long term, only attention (p = 0.043) and executive (p = 0.019) domains intervened. Overall, these results confirm the importance of a domain-specific approach to target cognitive recovery across time in stroke patients.
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Affiliation(s)
- Benedetta Basagni
- IRCCS Fondazione Don Carlo Gnocchi, 50143 Firenze, Italy; (B.B.); (S.M.); (C.P.); (L.P.); (S.P.); (A.M.); (P.G.); (E.S.); (S.M.); (B.H.); (A.G.); (C.M.); (F.C.)
| | - Serena Malloggi
- IRCCS Fondazione Don Carlo Gnocchi, 50143 Firenze, Italy; (B.B.); (S.M.); (C.P.); (L.P.); (S.P.); (A.M.); (P.G.); (E.S.); (S.M.); (B.H.); (A.G.); (C.M.); (F.C.)
| | - Cristina Polito
- IRCCS Fondazione Don Carlo Gnocchi, 50143 Firenze, Italy; (B.B.); (S.M.); (C.P.); (L.P.); (S.P.); (A.M.); (P.G.); (E.S.); (S.M.); (B.H.); (A.G.); (C.M.); (F.C.)
| | - Leonardo Pellicciari
- IRCCS Fondazione Don Carlo Gnocchi, 50143 Firenze, Italy; (B.B.); (S.M.); (C.P.); (L.P.); (S.P.); (A.M.); (P.G.); (E.S.); (S.M.); (B.H.); (A.G.); (C.M.); (F.C.)
| | - Silvia Campagnini
- IRCCS Fondazione Don Carlo Gnocchi, 50143 Firenze, Italy; (B.B.); (S.M.); (C.P.); (L.P.); (S.P.); (A.M.); (P.G.); (E.S.); (S.M.); (B.H.); (A.G.); (C.M.); (F.C.)
| | - Silvia Pancani
- IRCCS Fondazione Don Carlo Gnocchi, 50143 Firenze, Italy; (B.B.); (S.M.); (C.P.); (L.P.); (S.P.); (A.M.); (P.G.); (E.S.); (S.M.); (B.H.); (A.G.); (C.M.); (F.C.)
| | - Andrea Mannini
- IRCCS Fondazione Don Carlo Gnocchi, 50143 Firenze, Italy; (B.B.); (S.M.); (C.P.); (L.P.); (S.P.); (A.M.); (P.G.); (E.S.); (S.M.); (B.H.); (A.G.); (C.M.); (F.C.)
| | - Paola Gemignani
- IRCCS Fondazione Don Carlo Gnocchi, 50143 Firenze, Italy; (B.B.); (S.M.); (C.P.); (L.P.); (S.P.); (A.M.); (P.G.); (E.S.); (S.M.); (B.H.); (A.G.); (C.M.); (F.C.)
| | - Emilia Salvadori
- IRCCS Fondazione Don Carlo Gnocchi, 50143 Firenze, Italy; (B.B.); (S.M.); (C.P.); (L.P.); (S.P.); (A.M.); (P.G.); (E.S.); (S.M.); (B.H.); (A.G.); (C.M.); (F.C.)
| | - Sara Marignani
- IRCCS Fondazione Don Carlo Gnocchi, 50143 Firenze, Italy; (B.B.); (S.M.); (C.P.); (L.P.); (S.P.); (A.M.); (P.G.); (E.S.); (S.M.); (B.H.); (A.G.); (C.M.); (F.C.)
| | - Fabio Giovannelli
- Department of NEUROFARBA, University of Florence, 50143 Firenze, Italy; (F.G.); (M.P.V.)
| | - Maria Pia Viggiano
- Department of NEUROFARBA, University of Florence, 50143 Firenze, Italy; (F.G.); (M.P.V.)
| | - Bahia Hakiki
- IRCCS Fondazione Don Carlo Gnocchi, 50143 Firenze, Italy; (B.B.); (S.M.); (C.P.); (L.P.); (S.P.); (A.M.); (P.G.); (E.S.); (S.M.); (B.H.); (A.G.); (C.M.); (F.C.)
| | - Antonello Grippo
- IRCCS Fondazione Don Carlo Gnocchi, 50143 Firenze, Italy; (B.B.); (S.M.); (C.P.); (L.P.); (S.P.); (A.M.); (P.G.); (E.S.); (S.M.); (B.H.); (A.G.); (C.M.); (F.C.)
| | - Claudio Macchi
- IRCCS Fondazione Don Carlo Gnocchi, 50143 Firenze, Italy; (B.B.); (S.M.); (C.P.); (L.P.); (S.P.); (A.M.); (P.G.); (E.S.); (S.M.); (B.H.); (A.G.); (C.M.); (F.C.)
- Department of Experimental and Clinical Medicine, University of Florence, 50143 Firenze, Italy
| | - Francesca Cecchi
- IRCCS Fondazione Don Carlo Gnocchi, 50143 Firenze, Italy; (B.B.); (S.M.); (C.P.); (L.P.); (S.P.); (A.M.); (P.G.); (E.S.); (S.M.); (B.H.); (A.G.); (C.M.); (F.C.)
- Department of Experimental and Clinical Medicine, University of Florence, 50143 Firenze, Italy
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12
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Kiper P, Godart N, Cavalier M, Berard C, Cieślik B, Federico S, Kiper A, Pellicciari L, Meroni R. Effects of Immersive Virtual Reality on Upper-Extremity Stroke Rehabilitation: A Systematic Review with Meta-Analysis. J Clin Med 2023; 13:146. [PMID: 38202153 PMCID: PMC10780020 DOI: 10.3390/jcm13010146] [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: 11/02/2023] [Revised: 12/07/2023] [Accepted: 12/22/2023] [Indexed: 01/12/2024] Open
Abstract
Virtual reality (VR) is an innovative rehabilitation tool increasingly used in stroke rehabilitation. Fully immersive VR is a type of VR that closely simulates real-life scenarios, providing a high level of immersion, and has shown promising results in improving rehabilitation functions. This study aimed to assess the effect of immersive VR-based therapy for stroke patients on the upper extremities, activities of daily living (ADLs), and pain reduction and its acceptability and side effects. For this review, we gathered all suitable randomized controlled trials from PubMed, EMBASE, Cochrane Library, Scopus, and Web of Science. Out of 1532, 10 articles were included, with 324 participants. The results show that immersive VR offers greater benefits in comparison with conventional rehabilitation, with significant improvements observed in ADLs (SMD 0.58, 95% CI 0.25 to 0.91, I2 = 0%, p = 0.0005), overall function as measured by the Fugl-Meyer Assessment (MD 6.33, 95% CI 4.15 to 8.50, I2 = 25%, p = 0.00001), and subscales for the shoulder (MD 4.96, 95% CI-1.90-8.03, I2 = 25%, p = 0.002), wrist (MD 2.41, 95% CI-0.56-4.26, I2 = 0%, p = 0.01), and hand (MD 2.60, 95% CI-0.70-4.5°, I2 = 0%, p = 0.007). These findings highlight the potential of immersive VR as a valuable therapeutic option for stroke survivors, enhancing their ADL performance and upper-limb function. The immersive nature of VR provides an engaging and immersive environment for rehabilitation.
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Affiliation(s)
- Pawel Kiper
- Healthcare Innovation Technology Lab, IRCCS San Camillo Hospital, 30126 Venice, Italy (S.F.)
| | - Nathalie Godart
- Department of Physiotherapy, LUNEX International University of Health Exercise and Sports, L-4671 Differdange, Luxembourg; (N.G.)
| | - Manon Cavalier
- Department of Physiotherapy, LUNEX International University of Health Exercise and Sports, L-4671 Differdange, Luxembourg; (N.G.)
| | - Charlotte Berard
- Department of Physiotherapy, LUNEX International University of Health Exercise and Sports, L-4671 Differdange, Luxembourg; (N.G.)
| | - Błażej Cieślik
- Healthcare Innovation Technology Lab, IRCCS San Camillo Hospital, 30126 Venice, Italy (S.F.)
| | - Sara Federico
- Healthcare Innovation Technology Lab, IRCCS San Camillo Hospital, 30126 Venice, Italy (S.F.)
| | - Aleksandra Kiper
- Doctoral School of the University of Rzeszów, University of Rzeszów, 35-959 Rzeszów, Poland
| | | | - Roberto Meroni
- Department of Physiotherapy, LUNEX International University of Health Exercise and Sports, L-4671 Differdange, Luxembourg; (N.G.)
- Luxembourg Health & Sport Sciences Research Institute ASBL, L-4671 Differdange, Luxembourg
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13
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Barbato C, Antonucci L, Pellicciari L, Castagnoli C, Hochleitner I, Paperini A, Pancani S, Verdesca S, Basagni B, Macchi C, Cecchi F. Italian translation and transcultural validation of an assessment tool for community ambulation in stroke survivors: the modified Functional Walking Categories (mFWC). Physiother Theory Pract 2023; 39:2706-2714. [PMID: 35775498 DOI: 10.1080/09593985.2022.2094303] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Revised: 06/14/2022] [Accepted: 06/15/2022] [Indexed: 10/17/2022]
Abstract
BACKGROUND Community ambulation ability is one of the most important functional loss after stroke. The assessment of the level of community walking plays an important role in the multidimensional bio-psycho-social approach, to improve quality of life and social participation of stroke survivors. The modified Functional Walking Categories (mFWC) is a worldwide widely used tool to assess community ambulation in stroke survivors, but no Italian version is yet available. OBJECTIVE To cross-culturally adapt the mFWC into Italian and to assess its validity and reliability. METHODS According to the international guidelines, a multistep translation and cultural adaptation were conducted and revised by a committee of experts. Patients admitted to intensive inpatient rehabilitation with a sub-acute stroke were recruited. Inter- and intra-rater reliability and construct validity were studied. RESULTS Sixty patients with sub-acute stroke were prospectively enrolled in this study. Findings showed almost perfect intra- and inter-rater reliability (k = 1.000 [95% CI 1.000-1.000] and k = 0.984 [95% CI 0.955-1.000], respectively). The construct validity of the scale was satisfactory, as 100.0% a-priori hypotheses were met. CONCLUSIONS The Italian mFWC offers a valid tool for measuring community ambulation in stroke patients. Our work provides a validated and a cross-cultural adapted Italian version of the mFWC to accurately measure community ambulation both in clinical and research settings in Italy.
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Affiliation(s)
- Carmen Barbato
- PROMISE@LAB IRCCS Fondazione Don Carlo Gnocchi, Florence, Italy
| | | | | | | | | | - Anita Paperini
- PROMISE@LAB IRCCS Fondazione Don Carlo Gnocchi, Florence, Italy
| | - Silvia Pancani
- PROMISE@LAB IRCCS Fondazione Don Carlo Gnocchi, Florence, Italy
| | - Sonia Verdesca
- PROMISE@LAB IRCCS Fondazione Don Carlo Gnocchi, Florence, Italy
| | | | - Claudio Macchi
- PROMISE@LAB IRCCS Fondazione Don Carlo Gnocchi, Florence, Italy
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Francesca Cecchi
- PROMISE@LAB IRCCS Fondazione Don Carlo Gnocchi, Florence, Italy
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
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14
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Cordella M, Pellicciari L, Scopece F, Fornaro R, Giovannico G, Lanfranchi E. Evidence for exercise therapy in patients with hand and wrist tendinopathy is limited: A systematic review. J Hand Ther 2023; 36:940-955. [PMID: 37802688 DOI: 10.1016/j.jht.2023.08.016] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Revised: 08/21/2023] [Accepted: 08/21/2023] [Indexed: 10/08/2023]
Abstract
BACKGROUND Several studies reported the efficacy of exercise therapy in hand and wrist tendinopathy. However, no systematic review synthesized the effect of exercise therapy on these patients. PURPOSE This study aimed to perform a systematic review to summarize evidence if exercise therapy may be considered an effective treatment in conservative management for patients with hand and wrist tendinopathy. STUDY DESIGN This was a systematic review. METHODS A literature search in MEDLINE, Cochrane Library, PEDro, and Embase was conducted from their inception until April 10, 2022. Two independent reviewers included the studies administering exercise therapy in patients with hand and/or wrist tendinopathy in the review and extrapolated the data. Methodological quality was assessed using the framework developed by Murad et al for case reports and case series and the PEDro score for clinical trials. RESULTS Seven case reports, 3 case series, and 2 randomized controlled studies were included and methodologically evaluated, obtaining a low score for all the analyzed studies. The total number of included patients in the analyzed studies was 106, of which 54 were female, 13 were male, and 39 were not specified. The type of exercise was widespread and often not really well described: it varies from eccentric forearm training to mobilization with movement, passing through strengthening exercises, grip proprioception training, and self-management exercises according to the McKenzie method. The dosage was often not precise, making it difficult to reproduce the therapeutic proposals. Exercise therapy was always administered together with different treatments; therefore, its efficacy alone is difficult to distinguish, although in some cases, the patients improved pain and functionality. CONCLUSIONS Evidence on the efficacy of exercise therapy in patients with hand and wrist tendinopathies is limited. Future research is strongly recommended to determine the appropriate dosage of the exercise therapy to determine clinical changes in these patients.
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Affiliation(s)
- Marco Cordella
- Department of Medicine and Health Science "Vincenzo Tiberio", University of Molise, Campobasso, Italy; ASL Taranto, Taranto, Italy
| | | | - Fabrizio Scopece
- Department of Medicine and Health Science "Vincenzo Tiberio", University of Molise, Campobasso, Italy
| | - Roberta Fornaro
- Department of Medicine and Health Science "Vincenzo Tiberio", University of Molise, Campobasso, Italy
| | - Giuseppe Giovannico
- Department of Medicine and Health Science "Vincenzo Tiberio", University of Molise, Campobasso, Italy
| | - Elena Lanfranchi
- Department of Medicine and Health Science "Vincenzo Tiberio", University of Molise, Campobasso, Italy; Department of Biomedical and Neuromotor Sciences, Alma Mater Studiorum, University of Bologna, Bologna, Italy; Studio Lanfranchi - Private Practice, Bologna, Italy
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15
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Piscitelli D, Pellicciari L, Vidmar T, Kregar NG, Puh U. Is It Time to Go Beyond the Modified Ashworth Scale? Letter to the Editor on "Reliability of the Modified Ashworth Scale After Stroke for 13 Muscle Groups". Arch Phys Med Rehabil 2023; 104:1735-1736. [PMID: 37479163 DOI: 10.1016/j.apmr.2023.06.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2023] [Accepted: 06/03/2023] [Indexed: 07/23/2023]
Affiliation(s)
| | | | - Tjaša Vidmar
- Department of Rehabilitation of Patients After Stroke, University Rehabilitation Institute, Republic of Slovenia, Ljubljana, Slovenia.
| | - Nika Goljar Kregar
- Department of Rehabilitation of Patients After Stroke, University Rehabilitation Institute, Republic of Slovenia, Ljubljana, Slovenia
| | - Urška Puh
- Research and Development Unit, University Rehabilitation Institute, Republic of Slovenia, Ljubljana, Slovenia
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Hochleitner I, Pellicciari L, Castagnoli C, Paperini A, Politi AM, Campagnini S, Pancani S, Basagni B, Gerli F, Carrozza MC, Macchi C, Alt Murphy M, Cecchi F. Intra- and inter-rater reliability of the Italian Fugl-Meyer assessment of upper and lower extremity. Disabil Rehabil 2023; 45:2989-2999. [PMID: 36031950 DOI: 10.1080/09638288.2022.2114553] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Revised: 08/12/2022] [Accepted: 08/14/2022] [Indexed: 11/03/2022]
Abstract
PURPOSE To assess the intra- and inter-rater reliability motor and sensory functioning, balance, joint range of motion and joint pain subscales of the Italian Fugl-Meyer Assessment (FMA) Upper Extremity (FMA-UE) and Lower Extremity (FMA-LE) at the item- subtotal- and total-level in patients with sub-acute stroke. MATERIALS AND METHODS The FMA was administered to 60 patients with sub-acute stroke (mean age ± SD = 75.4 ± 10.7 years; 58.3% men) and independently rated by two physiotherapists on two consecutive days. Intra- and inter-reliability was studied by a rank-based statistical method for paired ordinal data to detect any systematic or random disagreement. RESULTS The item-level intra- and inter-rater reliability was satisfactory (>70%). Reliability level >70% was achieved at subscale and total score level when one- or two-points difference was considered. Systematic disagreements were reported for five items of the FMA-UE, but not for FMA-LE. CONCLUSIONS The Italian version of the FMA showed to be a reliable instrument that can therefore be recommended for clinical and research purposes.Implications for rehabilitationThe FMA is the gold standard for assessing stroke patients' sensorimotor impairment worldwide.The Italian Fugl-Meyer Assessment of Upper Extremity (FMA-UE) and Lower Extremity (FMA-LE) is substantially reliable within and between two raters at the item, subtotal, and total score level in patients with sub-acute stroke.The use of FMA in the Italian context will provide an opportunity for international comparisons and research collaborations.
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Affiliation(s)
| | | | | | | | | | - Silvia Campagnini
- IRCCS Fondazione Don Carlo Gnocchi, Florence, Italy
- Istituto di Biorobotica, Scuola Superiore Sant'Anna, Pontedera, Italy
| | | | | | | | | | - Claudio Macchi
- IRCCS Fondazione Don Carlo Gnocchi, Florence, Italy
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Margit Alt Murphy
- Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Occupational Therapy and Physiotherapy, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Francesca Cecchi
- IRCCS Fondazione Don Carlo Gnocchi, Florence, Italy
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
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Pournajaf S, Pellicciari L, Proietti S, Agostini F, Gabbani D, Goffredo M, Damiani C, Franceschini M. Which items of the modified Barthel Index can predict functional independence at discharge from inpatient rehabilitation? A secondary analysis retrospective cohort study. Int J Rehabil Res 2023; 46:230-237. [PMID: 37334818 PMCID: PMC10396075 DOI: 10.1097/mrr.0000000000000584] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Accepted: 05/21/2023] [Indexed: 06/21/2023]
Abstract
The modified Barthel Index (mBI) is a well-established patient-centered outcome measure commonly administrated in rehabilitation settings to evaluate the functional status of patients at admission and discharge. This study aimed to detect which mBI items collected on admission can predict the total mBI at discharge from first inpatient rehabilitation in large cohorts of orthopedic (n = 1864) and neurological (n = 1684) patients. Demographic and clinical data (time since the acute event 11.8 ± 17.2 days) at patients' admission and mBI at discharge were collected. Univariate and multiple binary logistic regressions were performed to study the associations between independent and dependent variables for each cohort separately. In neurological patients, the shorter time between the acute event and rehabilitation admission, shorter length of stay, and being independent with feeding, personal hygiene, bladder, and transfers were independently associated with higher total mBI at discharge (R 2 = 0.636). In orthopedic patients, age, the shorter time between the acute event and rehabilitation admission, shorter length of stay, and being independent with personal hygiene, dressing, and bladder were independently associated with higher total mBI at discharge (R 2 = 0.622). Our results showed that different activities in neurological (i.e. feeding, personal hygiene, bladder, and transfer) and orthopedic sample (i.e. personal hygiene, dressing, and bladder) are positively associated with better function (measured by mBI) at the discharge. Clinicians have to take into account these predictors of functionality when they plan an appropriate rehabilitation treatment.
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Affiliation(s)
- Sanaz Pournajaf
- Department of Neurological and Rehabilitation Science, IRCCS San Raffaele Roma, Rome
| | | | | | - Francesco Agostini
- Department of Neurological and Rehabilitation Science, IRCCS San Raffaele Roma, Rome
- Department of Anatomical and Histological Sciences, Legal Medicine and Orthopedics, Sapienza University of Rome
| | - Debora Gabbani
- Department of Neurological and Rehabilitation Science, IRCCS San Raffaele Roma, Rome
| | - Michela Goffredo
- Department of Neurological and Rehabilitation Science, IRCCS San Raffaele Roma, Rome
| | - Carlo Damiani
- Department of Neurological and Rehabilitation Science, IRCCS San Raffaele Roma, Rome
| | - Marco Franceschini
- Department of Neurological and Rehabilitation Science, IRCCS San Raffaele Roma, Rome
- San Raffaele University, Rome, Italy
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Al-Wardat M, Etoom M, Lena F, Pellicciari L, D’Amone F, Kossi O, Brindisino F, Abdullahi A. Exploring Communication Practices in Italian Physiotherapy: Knowledge and Use of Effective Communication Strategies-A National Descriptive Study. Healthcare (Basel) 2023; 11:2247. [PMID: 37628446 PMCID: PMC10454614 DOI: 10.3390/healthcare11162247] [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: 06/17/2023] [Revised: 08/07/2023] [Accepted: 08/08/2023] [Indexed: 08/27/2023] Open
Abstract
This study aimed to investigate the knowledge and use of effective communication strategies among Italian physiotherapists. We utilized a questionnaire consisting of 19 questions to collect data on the knowledge and use of effective communication strategies among Italian physiotherapists. The results revealed that only 35.8% of the respondents reported being aware of communication strategies related to physiotherapy, with their first exposure occurring during their three-year degree. Despite the majority of respondents agreeing that communication is an effective strategy for improving patient adherence, only about half reported making moderate use of open-ended questions and metaphors during treatment sessions. Furthermore, more than half of the respondents reported being unaware of Motivational Interviewing. The results of this study found that there is a consensus among Italian physiotherapists about the importance of effective communication in clinical practice, though the knowledge and application of some communication strategies remain limited. These findings suggest that there is room for improvement in the training and education of physiotherapists in Italy, with a need for greater emphasis on communication strategies in the university educational curriculum, starting from the bachelor's degree.
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Affiliation(s)
- Mohammad Al-Wardat
- Department of Rehabilitation Sciences, Faculty of Applied Medical Sciences, Jordan University of Science and Technology, Irbid 22110, Jordan
| | - Mohammad Etoom
- Department of Physical Therapy, Aqaba University of Technology, Aqaba 77110, Jordan;
| | - Francesco Lena
- IRCCS INM Neuromed, Department of Neurology, 86077 Pozzilli, Italy
| | | | - Francesco D’Amone
- Department of Medicine and Health Science, “Vincenzo Tiberio”, University of Molise, 86100 Campobasso, Italy; (F.D.); (F.B.)
| | - Oyéné Kossi
- ENATSE, National School of Public Health and Epidemiology, University of Parakou, Parakou 03 BP 10, Benin;
- Unit of Neurology and NeuroRehabilitation, University Hospital of Parakou, Parakou 01 BP 02, Benin
| | - Fabrizio Brindisino
- Department of Medicine and Health Science, “Vincenzo Tiberio”, University of Molise, 86100 Campobasso, Italy; (F.D.); (F.B.)
| | - Auwal Abdullahi
- Department of Physiotherapy, Bayero University, Kano 700271, Nigeria
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19
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Pellicciari L, Lucca LF, DE Tanti A, Formisano R, Estraneo A, Cava FC, Saviola D, LA Porta F. The structure of the Early Rehabilitation Barthel Index (ERBI) should be modified: evidence from a Rasch analysis study. Eur J Phys Rehabil Med 2023; 59:458-473. [PMID: 37534887 PMCID: PMC10595071 DOI: 10.23736/s1973-9087.23.07908-x] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Revised: 05/16/2023] [Accepted: 06/28/2023] [Indexed: 08/04/2023]
Abstract
BACKGROUND The Early Rehabilitation Barthel Index (ERBI) comprises seven items of the Early Rehabilitation Index and ten items of the Barthel Index. The ERBI is usually used to measure functional changes in patients with severe acquired brain injury (sABI), but its measurement properties have yet to be extensively assessed. AIM To study the unidimensionality and internal construct validity (ICV) of the ERBI through Confirmatory Factor Analysis (CFA), Mokken Analysis (MA), and Rasch Analysis (RA). DESIGN Multicenter prospective study. SETTING Inpatients from five intensive rehabilitation centers. POPULATION Two hundred and forty-seven subjects with sABI. METHODS ERBI was administered on admission and discharge to study its unidimensionality through CFA and MA and its ICV, reliability, and targeting through RA. RESULTS The preliminary analyses showed a lack of unidimensionality (RMSEA=0.460 >0.06; SRMR=0.176 >0.06; CFI=1.000 >0.950; TLI=1.000 >0.950). According to CFA, "Confusional state" and "Behavioral disturbance" items showed low factor loadings (<0.40), whereas these two items composed a separate scale within the MA. Furthermore, the baseline RA showed that three items misfitted ("Mechanical ventilation," "Confusional state," "Behavioral disturbances") and a lack of conformity of several ICV requirements. After deletion of three misfitting items and further non-structural modifications (i.e., testlets creation to absorb local dependence between items and item misfit), the solution obtained showed adequate ICV, adequate reliability for measurements at the individual level (PSI>0.85), although with a frank floor effect. This final solution was successfully replicated in a total sample of the subjects. After post-hoc modifications of the score structure of two out of three misfitting items, the subsequent CFA (RMSEA=0.044 <0.06; SRMR=0.056 <0.06; CFI=1.000 >0.950 TLI=1.000 >0.950) and MA showed the resolution of the unidimensional issues. CONCLUSIONS Although the ERBI is a potentially valuable tool for measuring functioning in the coma-to-community continuum, our analyses suggested its lack of ICV, partly due to an incorrect scoring design of some items. A new perspective multicenter study is proposed to validate a modified version of the ERBI that overcomes the problems highlighted in this analysis. CLINICAL REHABILITATION IMPACT Our results do not support the use of the original structure of the ERBI in clinical practice and research, as a lack of ICV was highlighted.
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Affiliation(s)
| | | | | | | | | | - Francesca C Cava
- Montecatone Rehabilitation Institute, Montecatone, Bologna, Italy
| | | | - Fabio LA Porta
- IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy -
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20
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Rossettini G, Pellicciari L, Turolla A. "Do Not Mix Apples with Oranges" to Avoid Misinterpretation of Placebo Effects in Manual Therapy: The Risk Is Resulting in a Fruit Basket. Comment on Molina-Àlvarez et al. Manual Therapy Effect in Placebo-Controlled Trials: A Systematic Review and Meta-Analysis. Int. J. Environ. Res. Public Health 2022, 19, 14021. Int J Environ Res Public Health 2023; 20:6444. [PMID: 37568986 PMCID: PMC10418991 DOI: 10.3390/ijerph20156444] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Revised: 04/12/2023] [Accepted: 07/06/2023] [Indexed: 08/13/2023]
Abstract
We read with interest the systematic review with the meta-analysis by Miguel Molina-Álvarez et al. [...].
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Affiliation(s)
| | | | - Andrea Turolla
- Department of Biomedical and Neuromotor Sciences (DIBINEM), Alma Mater Studiorum University of Bologna, 40126 Bologna, Italy
- Unit of Occupational Medicine, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy
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21
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Bargeri S, Pellicciari L, Gallo C, Rossettini G, Castellini G, Gianola S. What is the landscape of evidence about the safety of physical agents used in physical medicine and rehabilitation? A scoping review. BMJ Open 2023; 13:e068134. [PMID: 37355261 PMCID: PMC10314460 DOI: 10.1136/bmjopen-2022-068134] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Accepted: 05/31/2023] [Indexed: 06/26/2023] Open
Abstract
BACKGROUND Several systematic reviews (SRs) assessing the effectiveness of superficial physical agents have been published, but the evidence about their safety remains controversial. OBJECTIVE To identify areas where there is evidence of the safety of physical agents by a scoping review. DESIGN Four databases were systematically searched for including English SRs that explored and reported safety in terms of adverse events (AEs) related to the application of physical agents in outpatient and inpatient physical medicine and rehabilitation settings managed by healthcare professionals, published in January 2011-29 September 2021. The severity of AEs was classified according to the Common Terminology Criteria. Then, AE findings were summarised according to the SR syntheses. Finally, the reporting of the certainty of the evidence was mapped. RESULTS Overall, 117 SRs were retrieved. Most of the SRs included randomised controlled trials (77%) and patients with musculoskeletal disorders (67%). The most investigated physical agents were extracorporeal shock wave therapy (ESWT) (15%), transcutaneous electrical nerve stimulation (13%) and electrical stimulation (12%). No AE (35%) was reported in one-third of the included primary studies in SRs, whereas few severe AEs occurred in less than 1% of the sample. Among physical agents, ESWT showed an increased risk of experiencing mild AEs compared with the control. Most SRs reported a qualitative AE synthesis (65.8%), and few reported the certainty of the evidence (17.9%), which was mainly low. CONCLUSION We found evidence of safety on several physical agents coming mostly from qualitative synthesis. No significant harms of these interventions were found except for ESWT reporting mild AEs. More attention to the AEs reporting and their classification should be pursued to analyse them and assess the certainty of evidence quantitatively. REVIEW REGISTRATION https://osf.io/6vx5a/.
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Affiliation(s)
- Silvia Bargeri
- Unit of Clinical Epidemiology, IRCCS Istituto Ortopedico Galeazzi, Milan, Italy
| | | | - Chiara Gallo
- Fisiopoint Physical Therapy Department, Rome, Italy
| | | | - Greta Castellini
- Unit of Clinical Epidemiology, IRCCS Istituto Ortopedico Galeazzi, Milan, Italy
| | - Silvia Gianola
- Unit of Clinical Epidemiology, IRCCS Istituto Ortopedico Galeazzi, Milan, Italy
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22
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Brindisino F, Lorusso M, Usai M, Pellicciari L, Marruganti S, Salomon M. Rehabilitation following shoulder arthroplasty: a survey of current clinical practice patterns of Italian physiotherapists. Arch Physiother 2023; 13:12. [PMID: 37277886 DOI: 10.1186/s40945-023-00166-5] [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: 07/12/2022] [Accepted: 05/15/2023] [Indexed: 06/07/2023] Open
Abstract
BACKGROUND The incidence of Total Shoulder Arthroplasty (TSA) and Reverse Total Shoulder Arthroplasty (RTSA) is constantly increasing. As a result, the interest in post-surgical rehabilitation has grown, since it is crucial in order to achieve full recovery and successful outcomes. The first aim of this study is to investigate the Italian physiotherapists (PTs) clinical practice in the management of patients with TSA and RTSA and to compare it with the best evidence available in the literature. The second purpose of this study is to assess any existing difference between the survey answers and the different sample subgroups. MATERIALS AND METHODS This cross-sectional observation study was designed following the CHERRIES checklist and the STROBE guidelines. A 4-sections survey with a total of 30 questions was developed for investigating post-surgery rehabilitation management in patient with TSA and RTSA. The survey was sent to Italian PTs from December 2020 until February 2021. RESULTS Six-hundred and seven PTs completed the survey regarding both TSA and RTSA; 43.5% of participants (n = 264/607) stated that TSA is more likely to dislocate during abduction and external rotation. Regarding reverse prosthesis, 53.5% (n = 325/607) affirmed RTSA is more likely to dislocate during internal rotation, adduction and extension. In order to recover passive Range of Motion (pROM), 62.1% (n = 377/607) of participants reported that they gain anterior flexion, abduction, internal rotation, external rotation up to 30°, with full pROM in all directions granted at 6-12 weeks. Regarding the active ROM (aROM), 44.2% (n = 268/607) of participants stated that they use active-assisted procedures within a range under 90° of elevation and abduction at 3-4 weeks and higher than 90° at 6-12 weeks, with full recovery at a 3-month mark. Sixty-five point seven percent of the sample (n = 399/607) declared that, during the rehabilitation of patients with TSA, they tend to focus on strengthening the scapular and rotator cuff muscles, deltoid, biceps and triceps. Conversely, 68.0% (n = 413/607) of participants stated that, for the rehabilitation of patients with RTSA, they preferably focus on strengthening the periscapular and deltoid muscles. Finally, 33.1% (n = 201/607) of participants indicated the instability of the glenoid prosthetic component as the most frequent complication in patients with TSA, while 42.5% (n = 258/607) of PTs identified scapular neck erosion as the most frequent post-RTSA surgery complication. CONCLUSIONS The clinical practice of Italian PTs effectively reflects the indications of the literature as far as the strengthening of the main muscle groups and the prevention of movements, which may result in a dislocation, are concerned. Some differences emerged in the clinical practice of Italian PTs, regarding the restoration of active and passive movement, the starting and progression of muscle strengthening and the return to sport (RTS). These differences are actually quite representative of the current knowledge in post-surgical rehabilitation for shoulder prosthesis in the rehabilitation field. LEVEL OF EVIDENCE V.
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Affiliation(s)
- Fabrizio Brindisino
- Department of Medicine and Health Science "Vincenzo Tiberio", University of Molise, Campobasso, Italy.
| | - Mariangela Lorusso
- Department of Clinical Science and Traslational Medicine, University of Roma "Tor Vergata", Rome, Italy
| | | | | | - Sharon Marruganti
- Department of Clinical Science and Traslational Medicine, University of Roma "Tor Vergata", Rome, Italy
| | - Mattia Salomon
- Department of Clinical Science and Traslational Medicine, University of Roma "Tor Vergata", Rome, Italy
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23
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Goffredo M, Pagliari C, Turolla A, Tassorelli C, Di Tella S, Federico S, Pournajaf S, Jonsdottir J, De Icco R, Pellicciari L, Calabrò RS, Baglio F, Franceschini M. Non-Immersive Virtual Reality Telerehabilitation System Improves Postural Balance in People with Chronic Neurological Diseases. J Clin Med 2023; 12:jcm12093178. [PMID: 37176618 PMCID: PMC10179507 DOI: 10.3390/jcm12093178] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [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: 02/07/2023] [Revised: 04/19/2023] [Accepted: 04/21/2023] [Indexed: 05/15/2023] Open
Abstract
BACKGROUND People with chronic neurological diseases, such as Parkinson's Disease (PD) and Multiple Sclerosis (MS), often present postural disorders and a high risk of falling. When difficulties in achieving outpatient rehabilitation services occur, a solution to guarantee the continuity of care may be telerehabilitation. This study intends to expand the scope of our previously published research on the impact of telerehabilitation on quality of life in an MS sample, testing the impact of this type of intervention in a larger sample of neurological patients also including PD individuals on postural balance. METHODS We included 60 participants with MS and 72 with PD. All enrolled subjects were randomized into two groups: 65 in the intervention group and 67 in the control group. Both treatments lasted 30-40 sessions (5 days/week, 6-8 weeks). Motor, cognitive, and participation outcomes were registered before and after the treatments. RESULTS All participants improved the outcomes at the end of the treatments. The study's primary outcome (Mini-BESTest) registered a greater significant improvement in the telerehabilitation group than in the control group. CONCLUSIONS Our results demonstrated that non-immersive virtual reality telerehabilitation is well tolerated and positively affects static and dynamic balance and gait in people with PD and MS.
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Affiliation(s)
- Michela Goffredo
- Neurorehabilitation Research Laboratory, Department of Neurological and Rehabilitation Sciences, IRCCS San Raffaele Roma, 00163 Rome, Italy
| | - Chiara Pagliari
- IRCCS Fondazione Don Carlo Gnocchi ONLUS, 20148 Milan, Italy
| | - Andrea Turolla
- Department of Biomedical and Neuromotor Sciences (DIBINEM), Alma Mater University of Bologna, 40138 Bologna, Italy
- Unit of Occupational Medicine, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy
| | - Cristina Tassorelli
- Department of Brain and Behavioral Sciences, University of Pavia, 27100 Pavia, Italy
- Headache Science & Neurorehabilitation Center, IRCCS Mondino Foundation, 27100 Pavia, Italy
| | - Sonia Di Tella
- IRCCS Fondazione Don Carlo Gnocchi ONLUS, 20148 Milan, Italy
| | - Sara Federico
- Laboratory of Healthcare Innovation Technology, IRCCS San Camillo Hospital, 30126 Venice, Italy
| | - Sanaz Pournajaf
- Neurorehabilitation Research Laboratory, Department of Neurological and Rehabilitation Sciences, IRCCS San Raffaele Roma, 00163 Rome, Italy
| | | | - Roberto De Icco
- Department of Brain and Behavioral Sciences, University of Pavia, 27100 Pavia, Italy
- Headache Science & Neurorehabilitation Center, IRCCS Mondino Foundation, 27100 Pavia, Italy
| | | | | | | | - Marco Franceschini
- Neurorehabilitation Research Laboratory, Department of Neurological and Rehabilitation Sciences, IRCCS San Raffaele Roma, 00163 Rome, Italy
- Department of Human Sciences and Promotion of the Quality of Life, San Raffaele University, 00166 Rome, Italy
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24
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Venturin D, Giannotta G, Pellicciari L, Rossi A, Pennella D, Goffredo M, Poser A. Reliability and validity of the Shoulder Pain and Disability Index in a sample of patients with frozen shoulder. BMC Musculoskelet Disord 2023; 24:212. [PMID: 36949437 PMCID: PMC10032005 DOI: 10.1186/s12891-023-06268-2] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Accepted: 02/23/2023] [Indexed: 03/24/2023] Open
Abstract
BACKGROUND The Shoulder and Pain Disability Index (SPADI) is a widely used outcome measure. The aim of this study is to explore the reliability and validity of SPADI in a sample of patients with idiopathic frozen shoulder. METHODS The SPADI was administered to 124 patients with idiopathic frozen shoulder. A sub-group of 29 patients were retested after 7 days. SPADI scores were correlated with other outcome measures (i.e., Disabilities of the Arm, Shoulder and Hand Questionnaire - DASH; Numerical Pain Rating Scale-NPRS; and 36-item Short Form Health Survey-SF-36) to examine construct validity. Structural validity was assessed by a Two-Factors Confirmatory Factor Analysis (CFA). Internal consistency, test-retest reliability, and measurement error were also analyzed. RESULTS The construct validity was satisfactory as seven out of eight of the expected correlations formulated (≥ 75%) for the subscales were satisfied. The CFA showed good values of all indicators for both Pain and Disability subscales (Comparative Fit Index = 0.999; Tucker-Lewis Index = 0.997; Root Mean Square Error of Approximation = 0.030). Internal consistency was good for pain (α = 0.859) and disability (α = 0.895) subscales. High test-retest reliability (Intraclass correlation coefficient [ICC]) was found for pain (ICC = 0.989 [95% Confidence Interval (CI = 0.975-0.995]) and disability (ICC = 0.990 [95% CI = 0.988-0.998]). Standard Error of Measurement values of 2.27 and 2.32 and Minimal Detectable Change values of 6.27 and 6.25 were calculated for pain and disability subscales, respectively. CONCLUSION The SPADI demonstrated satisfactory reliability and validity properties in a sample of patients with idiopathic frozen shoulder.
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Affiliation(s)
- Davide Venturin
- Kinè Physiotherapic and Orthopedic Center, San Vendemiano, Treviso, Italy
- Department of Medicine and Health Science "Vincenzo Tiberio", University of Molise, Campobasso, Italy
| | - Gabriele Giannotta
- Department of Medicine and Health Science "Vincenzo Tiberio", University of Molise, Campobasso, Italy
- In Corpore Sano, Physiotherapic Clinic, Lecce, Italy
| | | | - Alex Rossi
- Kinè Physiotherapic and Orthopedic Center, San Vendemiano, Treviso, Italy
- University of Rome "Tor Vergata", Rome, Italy
| | - Denis Pennella
- Department of Medicine and Health Science "Vincenzo Tiberio", University of Molise, Campobasso, Italy
- "Manual Therapy Lab" Clinic, Bari, Italy
| | - Michela Goffredo
- Department of Neurological and Rehabilitation Sciences, IRCCS San Raffaele Roma, Via Della Pisana 235, 00163, Rome, Italy.
| | - Antonio Poser
- Kinè Physiotherapic and Orthopedic Center, San Vendemiano, Treviso, Italy
- University of Padua, Padua, Italy
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25
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Pellicciari L, Sodero A, Campagnini S, Guolo E, Basagni B, Castagnoli C, Hochleitner I, Paperini A, Gnetti B, Avila L, Romano E, Grippo A, Hakiki B, Carrozza MC, Mannini A, Macchi C, Cecchi F. Factors influencing trunk control recovery after intensive rehabilitation in post-stroke patients: a multicentre prospective study. Top Stroke Rehabil 2023; 30:109-118. [PMID: 34994302 DOI: 10.1080/10749357.2021.2016099] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
BACKGROUND Trunk control plays a crucial role in the stroke rehabilitation, but it is unclear which factors could influence the trunk control after an intensive rehabilitation treatment. OBJECTIVES To study which demographic, clinical and functional variables could predict the recovery of trunk control after intensive post-stroke inpatient rehabilitation. METHODS Subjects with acute, first-ever stroke were enrolled and clinical and data were collected at admission and discharge. The primary outcome was considered the trunk control measured by the Trunk Control Test (TCT). The data were analyzed by a univariate and multivariate logistic regressions. RESULTS Two hundred forty-one post-stroke patients were included. All baseline variables significantly associated to TCT at discharge in the univariate analysis (i.e. gender, NIHSS neglect item at admission, presence of several complexity markers, TCT total score at admission, NIHSS total score, pre-stroke modified Rankin Scale, Fugl-Meyer Assessment motor and sensitivity score) were entered in the multivariate analysis. The multivariate regression showed that age (p = .003), admission NIHSS total score (p = .001), admission TCT total score (p < .001) and presence of depression (p = .027) independently influenced the TCT total score at discharge (R2 = 61.2%). CONCLUSIONS Age, admission neurological impairment (NIHSS total score), trunk control at the admission (TCT total score), and presence of depression independently influenced the TCT at discharge. These factors should be carefully assessed at the baseline to plan a tailoring rehabilitation treatment achieving the best trunk control performance at discharge.
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Affiliation(s)
| | - Alessandro Sodero
- IRCCS Fondazione Don Carlo Gnocchi, Florence, Italy.,NEUROFARBA Department, Neuroscience Section, University of Florence, Florence, Italy
| | - Silvia Campagnini
- IRCCS Fondazione Don Carlo Gnocchi, Florence, Italy.,Istituto di Biorobotica, Scuola Superiore Sant'Anna, Pontedera, Italy
| | - Erika Guolo
- IRCCS Fondazione Don Carlo Gnocchi, Florence, Italy
| | | | | | | | | | | | - Lucia Avila
- Fondazione Don Carlo Gnocchi, Marina di Massa, Italy
| | | | - Antonello Grippo
- SOD Neurofisiopatologia, Dipartimento Neuromuscolo-Scheletrico e degli Organi di Senso, Azienda Ospedaliero Universitaria Careggi, Florence, Italy
| | - Bahia Hakiki
- IRCCS Fondazione Don Carlo Gnocchi, Florence, Italy
| | | | - Andrea Mannini
- IRCCS Fondazione Don Carlo Gnocchi, Florence, Italy.,Istituto di Biorobotica, Scuola Superiore Sant'Anna, Pontedera, Italy
| | - Claudio Macchi
- IRCCS Fondazione Don Carlo Gnocchi, Florence, Italy.,Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Francesca Cecchi
- IRCCS Fondazione Don Carlo Gnocchi, Florence, Italy.,Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
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26
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Castagnoli C, Pancani S, Barretta T, Pellicciari L, Campagnini S, Basagni B, Gucci C, Sodero A, Guolo E, Hakiki B, Grippo A, Mannini A, Macchi C, Cecchi F. Correlates of participation six months after stroke in an Italian population: results from the RIPS (Post-Stroke Intensive Rehabilitation) Study. Eur J Phys Rehabil Med 2023; 59:125-135. [PMID: 36723055 PMCID: PMC10172846 DOI: 10.23736/s1973-9087.23.07639-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
BACKGROUND Stroke survivors report physical, cognitive, and psychological impairments, with a consequent limitation of participation. Participation is the most context-related dimension of functioning, but the literature on participation in Italian stroke patients is scant. AIM This study aimed to describe the recovery of participation six months after stroke with a validated Italian version of the Frenchay Activity Index (FAI) and to investigate potential correlates with higher participation scores. DESIGN The study is a prospective observational study. SETTING The cohort of patients was enrolled in four intensive inpatient rehabilitation units of IRCCS Fondazione Don Carlo Gnocchi Onlus, Florence, Italy. POPULATION Adults addressing postacute intensive inpatient rehabilitation after an ischemic or hemorrhagic stroke occurred within 30 days from recruitment were prospectively enrolled. METHODS Data were collected at admission to intensive inpatient rehabilitation, and a six-month follow-up. The primary outcome was participation, measured by a validated Italian version of the FAI; only patients whose data included both anamnestic FAI and FAI at six months follow-up were included in this analysis. The data were analyzed by univariate and multivariate linear regressions. RESULTS A cohort of 105 patients (median age 78 years [interquartile range, IQR=21]; 46.7% males) with completed FAI at follow-up were included in this study. The sample reported a FAI median score of 28 (IQR=8) at admission (referred to the participation in the 3-6 months before the stroke) and 13 (IQR=20) at follow-up. All items were significantly affected, with the exception of reading and making trips. The multivariate regression for all patients with good participation before the stroke (N.=101), showed that 6 months after the stroke a higher FAI Score was independently associated with better functioning in activities of daily living (modified Barthel Index) (B=0.133; P=0.015), and absence of cognitive impairment (B=4.755; P=0.027); a lower stroke severity in the postacute phase (NIHSS B=-0.832; P=0.001) and a higher prestroke FAI Score (B=0.410; P=0.028) were also independently related to follow-up FAI Score. CONCLUSIONS In our cohort of patients addressing postacute stroke rehabilitation, prestroke participation levels were on average good, while they were severely reduced six months after stroke for all the considered items except reading and making trips. Higher FAI at follow-up was independently associated with a higher functional level and no cognitive impairment at follow-up, with lower stroke severity in the postacute phase, as well as a higher anamnestic participation score. CLINICAL REHABILITATION IMPACT Our results suggest that investigating prestroke participation may be highly relevant to predict, and possibly address, participation recovery after stroke.
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Affiliation(s)
| | - Silvia Pancani
- IRCCS Fondazione Don Carlo Gnocchi Onlus, Florence, Italy
| | | | | | - Silvia Campagnini
- IRCCS Fondazione Don Carlo Gnocchi Onlus, Florence, Italy - .,Sant'Anna School of Advanced Studies, The Biorobotics Institute, Pontedera, Pisa, Italy
| | | | - Camilla Gucci
- IRCCS Fondazione Don Carlo Gnocchi Onlus, Florence, Italy
| | - Alessandro Sodero
- IRCCS Fondazione Don Carlo Gnocchi Onlus, Florence, Italy.,Section of Neuroscience, NEUROFARBA Department, University of Florence, Florence, Italy
| | - Erika Guolo
- IRCCS Fondazione Don Carlo Gnocchi Onlus, Florence, Italy
| | - Bahia Hakiki
- IRCCS Fondazione Don Carlo Gnocchi Onlus, Florence, Italy
| | | | - Andrea Mannini
- IRCCS Fondazione Don Carlo Gnocchi Onlus, Florence, Italy
| | - Claudio Macchi
- IRCCS Fondazione Don Carlo Gnocchi Onlus, Florence, Italy.,Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Francesca Cecchi
- IRCCS Fondazione Don Carlo Gnocchi Onlus, Florence, Italy.,Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
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Angilecchia D, Stano F, Signorelli M, Giovannico G, Pournajaf S, Pellicciari L. Psychometric properties of the Italian version of the Forgotten Joint Score in patients with total hip arthroplasty. Int J Rehabil Res 2022; 45:343-349. [PMID: 36197448 DOI: 10.1097/mrr.0000000000000549] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Total hip arthroplasty (THA) surgeries are increasing; to assess quality of life after THA, an instrument that considers patient's perspective on surgical outcomes is necessary. The objective of this study is to assess the psychometric properties of the Italian version of the Forgotten Joint Score (FJS-I) in patients with THA. The FJS-I was administered to 111 patients with THA, as well as the Western Ontario and McMaster Universities (WOMAC), Numerical Pain Rating Scale (NPRS), and the EuroQol 5D-5L (EQ-5D-5L). Structural validity [confirmatory factor analysis (CFA)], internal consistency (Cronbach's alpha), test-retest reliability [intraclass correlation coefficient (ICC 2,1 )], measurement error [standard error of the measurement (SEM)], and construct validity (hypothesis testing with correlation of the WOMAC, NPRS, and EQ-5D-5L) were assessed. In addition, the minimal detectable change (MDC) was computed. The result of CFA confirmed the one-factor structure. Internal consistency was supported (α = 0.944). A high test-retest reliability (ICC = 0.958; 95% confidence interval, 0.914-0.980) was found with an SEM and an MDC of 5.3 and 16.6 points, respectively. The a-priori hypotheses were fully met, determining the construct validity to be satisfactory. Psychometric properties of the FJS-I were confirmed, and it can be used for single-person assessment. Further research is suggested to refine its structural validity.
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Affiliation(s)
- Domenico Angilecchia
- Department of Medicine and Health Scienze "Vincenzo Tiberio", University of Molise, Campobasso
- Rehabilitation service - ASL, Bari
| | - Flavia Stano
- Department of Medicine and Health Scienze "Vincenzo Tiberio", University of Molise, Campobasso
| | | | - Giuseppe Giovannico
- Department of Medicine and Health Scienze "Vincenzo Tiberio", University of Molise, Campobasso
| | - Sanaz Pournajaf
- Neurorehabilitation Research Lab, Department of Neurological and Rehabilitation Sciences, IRCCS San Raffaele, Rome
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Pournajaf S, Goffredo M, Pellicciari L, Piscitelli D, Criscuolo S, Le Pera D, Damiani C, Franceschini M. Effect of balance training using virtual reality-based serious games in individuals with total knee replacement: A randomized controlled trial. Ann Phys Rehabil Med 2022; 65:101609. [PMID: 34839056 DOI: 10.1016/j.rehab.2021.101609] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Revised: 10/25/2021] [Accepted: 11/03/2021] [Indexed: 10/14/2022]
Abstract
BACKGROUND Virtual reality (VR) and serious games (SGs) are widespread in rehabilitation for many orthopedic and neurological diseases. However, few studies have addressed the effects of rehabilitation with VR-based SGs on clinical, gait, and postural outcomes in individuals with total knee replacement (TKR). OBJECTIVE The primary objective was the efficacy of balance training using non-immersive VR-based SGs compared to conventional therapy in TKR patients on the Time Up and Go test. Secondary objectives included the efficacy on clinical, gait, and postural outcomes. METHODS We randomly allocated 56 individuals with unilateral TKR to the experimental group (EG) or control group (CG) for 15 sessions (45 min; 5 times per week) of non-immersive VR-based SGs or conventional balance training, respectively. The primary outcome was functional mobility measured by the Timed Up and Go test; secondary outcomes were walking speed, pain intensity, lower-limb muscular strength, independence in activities of daily living as well as gait and postural parameters. RESULTS We found significant within-group differences in all clinical outcomes and in a subset of gait (p<0.0001) and postural (p ≤ 0.05) parameters. Analysis of the stance time of the affected limb revealed significant between-group differences (p = 0.022): post-hoc analysis revealed within-group differences in the EG (p = 0.002) but not CG (p = 0.834). We found no significant between-group differences in other outcomes. CONCLUSIONS Balance training with non-immersive VR-based SGs can improve clinical, gait, and postural outcomes in TKR patients. It was not superior to the CG findings but could be considered an alternative to the conventional approach and can be added to a regular rehabilitation program in TKR patients. The EG had a more physiological duration of the gait stance phase at the end of the treatment than the CG. CLINICALTRIALS GOV: NCT03454256.
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Affiliation(s)
- Sanaz Pournajaf
- Neurorehabilitation Research Laboratory, Department of Neurological and Rehabilitation Sciences, IRCCS San Raffaele Roma, Rome, Italy
| | - Michela Goffredo
- Neurorehabilitation Research Laboratory, Department of Neurological and Rehabilitation Sciences, IRCCS San Raffaele Roma, Rome, Italy
| | - Leonardo Pellicciari
- Neurorehabilitation Research Laboratory, Department of Neurological and Rehabilitation Sciences, IRCCS San Raffaele Roma, Rome, Italy.
| | - Daniele Piscitelli
- School of Physical and Occupational Therapy, McGill University, Montreal, Canada; School of Medicine and Surgery, University of Milano Bicocca, Milan, Italy
| | - Simone Criscuolo
- Neurorehabilitation Research Laboratory, Department of Neurological and Rehabilitation Sciences, IRCCS San Raffaele Roma, Rome, Italy
| | - Domenica Le Pera
- Neurorehabilitation Research Laboratory, Department of Neurological and Rehabilitation Sciences, IRCCS San Raffaele Roma, Rome, Italy
| | - Carlo Damiani
- Neurorehabilitation Research Laboratory, Department of Neurological and Rehabilitation Sciences, IRCCS San Raffaele Roma, Rome, Italy
| | - Marco Franceschini
- Neurorehabilitation Research Laboratory, Department of Neurological and Rehabilitation Sciences, IRCCS San Raffaele Roma, Rome, Italy; Department of Human Sciences and Promotion of the Quality of Life, San Raffaele University, Rome, Italy
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Chiavilli M, Campagnini S, Baretta T, Castagnoli C, Paperini A, Politi AM, Pellicciari L, Baccini M, Basagni B, Marignani S, Bardi D, Sodero A, Lombardi G, Guolo E, Navarro JS, Galeri S, Montesano A, Falco L, Rovaris MG, Carrozza MC, Macchi C, Mannini A, Cecchi F. Design and implementation of a Stroke Rehabilitation Registry for the systematic assessment of processes and outcomes and the development of data-driven prediction models: The STRATEGY study protocol. Front Neurol 2022; 13:919353. [PMID: 36299268 PMCID: PMC9588928 DOI: 10.3389/fneur.2022.919353] [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: 04/13/2022] [Accepted: 08/09/2022] [Indexed: 10/14/2023] Open
Abstract
BACKGROUND Stroke represents the second preventable cause of death after cardiovascular disease and the third global cause of disability. In countries where national registries of the clinical quality of stroke care have been established, the publication and sharing of the collected data have led to an improvement in the quality of care and survival of patients. However, information on rehabilitation processes and outcomes is often lacking, and predictors of functional outcomes remain poorly explored. This paper describes a multicenter study protocol to implement a Stroke rehabilitation Registry, mainly based on a multidimensional assessment proposed by the Italian Society of Physical and Rehabilitation Medicine (PMIC2020), in a pilot Italian cohort of stroke survivors undergoing post-acute inpatient rehabilitation, to provide a systematic assessment of processes and outcomes and develop data-driven prediction models of functional outcomes. METHODS All patients with a diagnosis of ischemic or haemorrhagic stroke confirmed by clinical assessment, admitted to intensive rehabilitation units within 30 days from the acute event, aged 18+, and providing informed consent will be enrolled. Measures will be taken at admission (T0), at discharge (T1), and at follow-up, 3 months (T2) and 6 months (T3) after the stroke. Assessment variables include anamnestic data, clinical and nursing complexity information and measures of body structures and function, activity and participation (PMIC2020), rehabilitation interventions, adverse events and discharge data. The modified Barthel Index will be our primary outcome. In addition to classical biostatistical analysis, learning algorithms will be cross-validated to achieve data-driven prognosis prediction models. CONCLUSIONS This study will test the feasibility of a stroke rehabilitation registry in the Italian health context and provide a systematic assessment of processes and outcomes for quality assessment and benchmarking. By the development of data-driven prediction models in stroke rehabilitation, this study will pave the way for the development of decision support tools for patient-oriented therapy planning and rehabilitation outcomes maximization. CLINICAL TIAL REGISTRATION The registration on ClinicalTrials.gov is ongoing and under review. The identification number will be provided when the review process will be completed.
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Affiliation(s)
| | - Silvia Campagnini
- IRCCS Fondazione Don Carlo Gnocchi onlus, Firenze, Italy
- The Biorobotics Institute, Scuola Superiore Sant'Anna, Pisa, Italy
| | - Teresa Baretta
- IRCCS Fondazione Don Carlo Gnocchi onlus, Firenze, Italy
| | | | - Anita Paperini
- IRCCS Fondazione Don Carlo Gnocchi onlus, Firenze, Italy
| | | | | | - Marco Baccini
- IRCCS Fondazione Don Carlo Gnocchi onlus, Firenze, Italy
| | | | - Sara Marignani
- IRCCS Fondazione Don Carlo Gnocchi onlus, Firenze, Italy
| | - Donata Bardi
- IRCCS Fondazione Don Carlo Gnocchi onlus, Firenze, Italy
| | - Alessandro Sodero
- IRCCS Fondazione Don Carlo Gnocchi onlus, Firenze, Italy
- NEUROFARBA Department, Neuroscience Section, University of Florence, Florence, Italy
| | - Gemma Lombardi
- IRCCS Fondazione Don Carlo Gnocchi onlus, Firenze, Italy
| | - Erika Guolo
- IRCCS Fondazione Don Carlo Gnocchi onlus, Firenze, Italy
| | | | - Silvia Galeri
- IRCCS Fondazione Don Carlo Gnocchi Onlus, Milan, Italy
| | | | - Lucia Falco
- IRCCS Fondazione Don Carlo Gnocchi Onlus, Milan, Italy
| | | | | | - Claudio Macchi
- IRCCS Fondazione Don Carlo Gnocchi onlus, Firenze, Italy
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Andrea Mannini
- IRCCS Fondazione Don Carlo Gnocchi onlus, Firenze, Italy
| | - Francesca Cecchi
- IRCCS Fondazione Don Carlo Gnocchi onlus, Firenze, Italy
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
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Mourad F, Yousif MS, Maselli F, Pellicciari L, Meroni R, Dunning J, Puentedura E, Taylor A, Kerry R, Hutting N, Kranenburg HA. Knowledge, beliefs, and attitudes of spinal manipulation: a cross-sectional survey of Italian physiotherapists. Chiropr Man Therap 2022; 30:38. [PMID: 36096835 PMCID: PMC9465888 DOI: 10.1186/s12998-022-00449-x] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Accepted: 09/06/2022] [Indexed: 11/13/2022] Open
Abstract
Background and Objective High-velocity low-amplitude thrust spinal manipulation (SM) is a recommended and commonly used manual therapy intervention in physiotherapy. Beliefs surrounding the safety and effectiveness of SM have challenged its use, and even advocated for its abandonment. Our study aimed to investigate the knowledge and beliefs surrounding SM by Italian physiotherapists compared with similar practitioners in other countries.
Methods An online survey with 41 questions was adapted from previous surveys and was distributed via a mailing list of the Italian Physiotherapists Association (March 22–26, 2020). The questionnaire was divided into 4 sections to capture information on participant demographics, utilization, potential barriers, and knowledge about SM. Questions were differentiated between spinal regions. Attitudes towards different spinal regions, attributes associated with beliefs, and the influence of previous educational background were each evaluated.
Results Of the 7398 registered physiotherapists, 575 (7.8%) completed the survey and were included for analysis. The majority of respondents perceived SM as safe and effective when applied to the thoracic (74.1%) and lumbar (72.2%) spines; whereas, a smaller proportion viewed SM to the upper cervical spine (56.8%) as safe and effective. Respondents reported they were less likely to provide and feel comfortable with upper cervical SM (respectively, 27.5% and 48.5%) compared to the thoracic (respectively, 52.2% and 74.8%) and lumbar spines (respectively, 46.3% and 74.3%). Most physiotherapists (70.4%) agreed they would perform additional screening prior to upper cervical SM compared to other spinal regions. Respondents who were aware of clinical prediction rules were more likely to report being comfortable with SM (OR 2.38–3.69) and to perceive it as safe (OR 1.75–3.12). Finally, physiotherapists without musculoskeletal specialization, especially those with a traditional manual therapy background, were more likely to perform additional screening prior to SM, use SM less frequently, report being less comfortable performing SM, and report upper cervical SM as less safe (p < 0.001). Discussion The beliefs and attitudes of physiotherapists surrounding the use of SM are significantly different when comparing the upper cervical spine to other spinal regions. An educational background in traditional manual therapy significantly influences beliefs and attitudes. We propose an updated framework on evidence-based SM. Supplementary Information The online version contains supplementary material available at 10.1186/s12998-022-00449-x.
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Affiliation(s)
- Firas Mourad
- Department of Physiotherapy, Exercise and Sports, LUNEX International University of Health, 4671, Differdange, Luxembourg. .,Luxembourg Health & Sport Sciences Research Institute A.S.B.L., 50, Avenue du Parc des Sports, 4671, Differdange, Luxembourg.
| | - Marzia Stella Yousif
- Department of Clinical Science and Translation Medicine, Faculty of Medicine and Surgery, University of Rome Tor Vergata, Rome, Italy
| | - Filippo Maselli
- Department of Human Neurosciences, Sapienza" University of Rome, Rome, Italy.,Sovrintendenza Sanitaria Regionale Puglia INAIL, Bari, Italy
| | | | - Roberto Meroni
- Department of Physiotherapy, Exercise and Sports, LUNEX International University of Health, 4671, Differdange, Luxembourg.,Luxembourg Health & Sport Sciences Research Institute A.S.B.L., 50, Avenue du Parc des Sports, 4671, Differdange, Luxembourg
| | - James Dunning
- American Academy of Manipulative Therapy Fellowship in Orthopaedic Manual Physical Therapy, Montgomery, AL, USA.,Montgomery Osteopractic Physiotherapy & Acupuncture Clinic, Montgomery, AL, USA
| | - Emilio Puentedura
- Doctor of Physical Therapy Program, Robbins College of Health and Human Sciences, Baylor University, Waco, TX, USA
| | - Alan Taylor
- Faculty of Medicine and Health Sciences, School of Health Sciences, University of Nottingham, Nottingham, UK
| | - Roger Kerry
- Faculty of Medicine and Health Sciences, School of Health Sciences, University of Nottingham, Nottingham, UK
| | - Nathan Hutting
- Department of Occupation and Health, School of Organisation and Development, HAN University of Applied Sciences, Nijmegen, The Netherlands
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de Ruvo R, Russo G, Lena F, Giovannico G, Neville C, Turolla A, Torre M, Pellicciari L. The Effect of Manual Therapy Plus Exercise in Patients with Lateral Ankle Sprains: A Critically Appraised Topic with a Meta-Analysis. J Clin Med 2022; 11:jcm11164925. [PMID: 36013167 PMCID: PMC9409935 DOI: 10.3390/jcm11164925] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Revised: 08/08/2022] [Accepted: 08/18/2022] [Indexed: 11/16/2022] Open
Abstract
A high percentage of patients with lateral ankle sprains report poor outcomes and persistent neuromuscular impairment leading to chronic ankle instability and re-injury. Several interventions have been proposed and investigated, but the evidence on manual therapy combined with therapeutic exercise for pain reduction and functional improvement is still uncertain. The purpose was to study the effectiveness of adding manual therapy to therapeutic exercise in patients with lateral ankle sprains through a critically appraised topic. The literature search was performed in PubMed, PEDro, EMBASE and CINAHL databases, and only randomized clinical trials were included according to following criteria: (1) subjects with acute episodes of lateral ankle sprains, (2) administered manual therapy plus therapeutic exercise, (3) comparisons with therapeutic exercise alone and (4) reported outcomes for pain and function. Three randomized clinical trials (for a total of 180 patients) were included in the research. Meta-analyses revealed that manual therapy plus exercise was more effective than only exercises in improving dorsal (MD = 8.79, 95% CI: 6.81, 10.77) and plantar flexion (MD = 8.85, 95% CI 7.07, 10.63), lower limb function (MD = 1.20, 95% CI 0.63, 1.77) and pain (MD = -1.23; 95% IC -1.73, -0.72). Manual therapy can be used with therapeutic exercise to improve clinical outcome in patients with lateral ankle sprains.
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Affiliation(s)
- Rocco de Ruvo
- Fondazione Centri di Riabilitazione “Padre Pio Onlus”, 71013 San Giovanni Rotondo, Italy
| | - Giuseppe Russo
- Department of Medicine and Health Science “Vincenzo Tiberio”, University of Molise, 86100 Campobasso, Italy
| | - Francesco Lena
- Department of Medicine and Health Science “Vincenzo Tiberio”, University of Molise, 86100 Campobasso, Italy
- IRCCS INM Neuromed, 86077 Isernia, Italy
| | - Giuseppe Giovannico
- Department of Medicine and Health Science “Vincenzo Tiberio”, University of Molise, 86100 Campobasso, Italy
- Correspondence:
| | - Christoper Neville
- Department of PT Education, Upstate Medical University, Syracuse, NY 13210, USA
| | - Andrea Turolla
- Dipartimento di Scienze Biomediche e Neuromotorie—DIBINEM, Università degli Studi di Bologna, 40126 Bologna, Italy
- IRCCS Azienda Ospedaliero-Universitaria, 40138 Bologna, Italy
| | - Monica Torre
- Sanstefar Abruzzo Riabilitazione, 65100 Pescara, Italy
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Faletra A, Bellin G, Dunning J, Fernández-de-Las-Peñas C, Pellicciari L, Brindisino F, Galeno E, Rossettini G, Maselli F, Severin R, Mourad F. Assessing cardiovascular parameters and risk factors in physical therapy practice: findings from a cross-sectional national survey and implication for clinical practice. BMC Musculoskelet Disord 2022; 23:749. [PMID: 35927658 PMCID: PMC9351255 DOI: 10.1186/s12891-022-05696-w] [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] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Accepted: 07/19/2022] [Indexed: 11/29/2022] Open
Abstract
Background Cardiovascular diseases are the leading cause of death and comorbidity worldwide. High blood pressure and resting heart rate are risk factors (or vital signs) critical to cardiovascular health, patient safety, and medical management. Physiotherapists play a fundamental role in risk factor identification, early diagnosis, and subsequent management of cardiovascular disease. To date there is limited research in Europe investigating the level of knowledge and skills possessed by physiotherapists regarding cardiovascular disease screening. Three studies previously observed inadequate vital signs screening behaviors of physiotherapists practicing in the United States and Saudi Arabia. The primary aim of this study was to investigate cardiovascular knowledge and screening practices among Italian physiotherapists, according to the current practice recommendations. Methods A Cross-Sectional Survey was developed adapting two previous surveys. The survey was administered to members of the Italian Physiotherapy Association. Chi squared test, Mann-Whitney test or Kruskal-Wallis test were used to study differences among subgroups and question responses. Results The required sample size was met with total of 387 Italian physiotherapists completing the survey. 80% consider relevant cardiovascular assessment. However, 72.2% were not familiar to guidelines recommendations and only 50% screen vital signs routinely. Their knowledge of normative blood pressure (high-normal, 16%; hypertension, 12%) and heart rate values (bradycardia, 24%; tachycardia, 26%) were low. Although participants reported being skilled for blood pressure measurement (quite sure, 52%; sure, 27%), their adherence to guidelines is low (baseline measurement on both arm, 25%; 3 repeated measures, 46%). Only 27.8% reported to measure exercise related BP and 21.3% of them understood the concept of exaggerated BP. No significant differences between subgroups were found. Conclusions Our study revealed that a concerning proportion of Italian physiotherapists are not versed in fundamentals of properly performing cardiovascular screenings. This lack of knowledge is present across the profession and may impact on appropriate triage and management. The poorly executed screening has the potential to negatively impact the patient and the practitioner. Given the absence of Italian guidelines, we produced and implemented three infographics for public use, which have the dual objective of raising awareness about this subject and providing practical resources for everyday practice. Supplementary Information The online version contains supplementary material available at 10.1186/s12891-022-05696-w.
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Affiliation(s)
- Agostino Faletra
- Clinical Support & Screening Service, Queen Elizabeth Hospital, Gateshead, United Kingdom
| | - Giuseppe Bellin
- Department of Physical Therapy, Centro Diagnostico Veneto, Vicenza, Italy
| | - James Dunning
- American Academy of Manipulative Therapy Fellowship in Orthopaedic Manual Physical Therapy, Montgomery, Alabama, USA.,Montgomery Osteopractic Physiotherapy & Acupuncture Clinic, Montgomery, Alabama, USA
| | - César Fernández-de-Las-Peñas
- Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos, Alcorcón, Spain.,Cátedra de Investigación, Clínica y Docencia en Fisioterapia: Terapia Manual, Punción Seca y Ejercicio, Universidad Rey Juan Carlos, Madrid, Alcorcón, Spain
| | | | - Fabrizio Brindisino
- Department of Medicine and Health Science "Vincenzo Tiberio", University of Molise c/o Cardarelli Hospital, Campobasso, Italy.,Department of clinical science and translation medicine, University of Rome Tor Vergata, Roma, Italy
| | - Erasmo Galeno
- Department of clinical science and translation medicine, University of Rome Tor Vergata, Roma, Italy.,Polimedico Specialistico STEMA Fisiolab, Latina, Italy.,Department of Medical Sciences, surgery and neuroscience, Università degli studi di Siena, Siena, Italy.,Department of Human Neurosciences, "Sapienza" University of Rome, Rome, Italy
| | | | - Filippo Maselli
- Department of Human Neurosciences, "Sapienza" University of Rome, Rome, Italy.,Sovrintendenza Sanitaria Regionale Puglia INAIL, Bari, Italy
| | - Richard Severin
- Department of Physical Therapy, University of Illinois at Chicago, College of Applied Health Sciences, Chicago, IL, USA.,Department of Physical Therapy, Baylor University, Robbins College of Applied Health Sciences, Waco, TX, USA
| | - Firas Mourad
- Department of Physiotherapy, LUNEX International University of Health, Exercise and Sports, 4671, Differdange, Luxembourg. .,Luxembourg Health & Sport Sciences Research Institute, A.s.b.l., 50, Avenue du Parc des Sports, 4671, Differdange, Luxembourg.
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Cristinziano M, Assenza C, Antenore C, Pellicciari L, Foti C, Morelli D. Telerehabilitation during COVID-19 lockdown and gross motor function in cerebral palsy: an observational study. Eur J Phys Rehabil Med 2022; 58:592-597. [PMID: 34913329 PMCID: PMC9980529 DOI: 10.23736/s1973-9087.21.07132-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND COVID-19 (Coronavirus disease 2019) refers to a mainly respiratory disease, caused by a new SARS-CoV-2 virus predominantly transmitted through direct or indirect contact with mucous membranes of eyes, mouth, or nose. The main control measures are physical distancing, use of specific protective devices, hand hygiene and disinfection of environments and tools. During this health emergency, telemedicine and telerehabilitation guaranteed patients to receive continuity of care through a virtual support while maintaining physical distance. AIM The aim of this study was to evaluate the effects of telerehabilitation on gross motor skills in children with cerebral palsy (CP) during COVID-19 lockdown. DESIGN This is an observational study. SETTING Pediatric Outpatient Neurorehabilitation Service. POPULATION Fifty-three children with cerebral palsy aged between 6 months and 12 years classified according to the Gross Motor Function Classification System (GMFCS). METHODS Variation on the Gross Motor Function Measure-66 (GMFM-66) Score calculated before and after the telerehabilitation period was analyzed. RESULTS After telerehabilitation there was a statistically significant increase in the median value of GMFM scores both on the total sample (from 54.82% to 63.18%, P=0.000005) and in the subgroups. Specifically, in children classified as level I and II at the GMFCS, this value increased more after the telerehabilitation period. Only the GMFCS level V group did not show statistically significant changes and only in two cases a decrease in the GMFM Score after the telerehabilitation phase occurred. CONCLUSIONS Telerehabilitation can be considered an efficient tool that can temporarily replace the in-person therapy. It can allow the patient or caregiver to acquire skills in performing home exercises and to integrate and implement activity carried out at the Rehabilitation Center. CLINICAL REHABILITATION IMPACT This study shows a positive effect of telerehabilitation on gross motor function in children with cerebral palsy.
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Affiliation(s)
- Martina Cristinziano
- Unit of Physical and Rehabilitation Medicine, Tor Vergata University, Rome, Italy -
| | - Carla Assenza
- Department of Pediatric Neurorehabilitation, Scientific Institute for Research and Health Care Santa Lucia Foundation, Rome, Italy
| | - Clementina Antenore
- Department of Pediatric Neurorehabilitation, Scientific Institute for Research and Health Care Santa Lucia Foundation, Rome, Italy
| | | | - Calogero Foti
- Unit of Physical and Rehabilitation Medicine, Tor Vergata University, Rome, Italy
| | - Daniela Morelli
- Department of Pediatric Neurorehabilitation, Scientific Institute for Research and Health Care Santa Lucia Foundation, Rome, Italy
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Pieri E, Bonetti F, Pellicciari L, Scipioni F. Well-described exercises for chronic low back pain in Life Science Literature: A systematic review. J Back Musculoskelet Rehabil 2022; 35:729-742. [PMID: 34957993 DOI: 10.3233/bmr-210179] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND Therapeutic exercise (TE) is recommended in multimodal treatment for patients with non-specific chronic back pain (cLBP). OBJECTIVE The aim of this study is to identify an exercise or a spectrum of exercises, well described and reproducible by the clinician, for cLBP patients. METHODS Systematic review by researching in the databases MEDLINE, EMBASE, PEDro, CINAHL, and Scopus. Evidence from Randomized Controlled Trials (RCTs) supported the TE in patients with non-specific cLBP, provided that it was well described and could be repeated by another therapist. Methodological evaluation was performed using the PEDro scale and only studies with a score of ⩾ 6 were included. The assessment of the intervention description was carried out with the TIDieR checklist. The risk of bias was examined. RESULTS Twenty-one articles were included in this systematic review. The defective description and the poorly reporting of the intervention makes it more difficult for the clinician to include the TE into clinical practice. CONCLUSIONS The findings of this study showed that the reporting of the intervention in high quality RCT on chronic low back pain is low, threatening the external validity of the results.
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Affiliation(s)
| | - Francesca Bonetti
- University of Rome Tor Vergata, Rome, Italy.,Physioup - Physiotherapy Practice, Rome Italy
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Antonucci L, Barbato C, Pellicciari L, Paperini A, Hochleitner I, Castagnoli C, Verdesca S, Lucidi G, Marignani S, Pancani S, Basagni B, Macchi C, Cecchi F. Italian translation and cross-cultural validation of an assessment tool for participation in stroke survivors: the Frenchay Activities Index. Neurol Sci 2022; 43:4297-4306. [PMID: 35179673 DOI: 10.1007/s10072-022-05949-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Accepted: 02/08/2022] [Indexed: 12/14/2022]
Abstract
PURPOSE Participation needs to be assessed objectively, to state accurate rehabilitation objectives. The Frenchay Activities Index (FAI) is a widely used tool to measure participation in stroke patients. To date, no cross-culturally validated Italian version of FAI is available. This study provides a translation and cross-cultural adaptation of FAI into Italian, assessing its validity and reliability in sub-acute stroke patients. METHODS According to international guidelines, a multistep translation and cultural adaptation protocol of forward and backward translations was conducted by qualified linguists and independent native English translators and revised by a healthcare committee. Patients admitted to intensive inpatient rehabilitation after stroke were recruited. Structural validity, reliability (internal consistency, inter- and intra-rater reliability and measurement error), and construct validity were studied. RESULTS One hundred and seventy-three patients were included in this study. No significant observations in terms of comprehensibility and conceptual equivalence of the FAI Italian version emerged. The exploratory factorial analysis revealed the presence of two subscales (i.e., domestic chores and work/leisure). The internal consistency resulted good for the first and second subscale (α = 0.821 and 0.716, respectively). Intra- and inter-reliability showed an ICC > 0.90 for both subscales. SEM = 5.75% and 2.33% and MDC = 15.85% and 6.48% were found for the first and second subscale, respectively. Construct validity of first subscale was satisfactory, as 100.0% a priori hypotheses were met, while for the second subscale it was moderate, as 66.6% a priori hypotheses were respected. CONCLUSION FAI-I provides a tool for professionals to measure participation in Italian stroke patients in health and social care settings.
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Affiliation(s)
- Laura Antonucci
- Physical and Rehabilitation Medicine, University of Florence, Florence, Italy
| | | | | | | | | | | | | | | | | | | | | | - Claudio Macchi
- IRCCS Fondazione Don Carlo Gnocchi, Florence, Italy
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Francesca Cecchi
- IRCCS Fondazione Don Carlo Gnocchi, Florence, Italy
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
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Valagussa G, Piscitelli D, Baruffini S, Panzeri V, Perin C, Mazzucchelli M, Cornaggia CM, Pellicciari L, Grossi E. Little Evidence for Conservative Toe Walking Interventions in Autism Spectrum Disorders: a Systematic Review. Rev J Autism Dev Disord 2022. [DOI: 10.1007/s40489-022-00329-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
AbstractThis systematic review summarizes the evidence about toe walking (TW) interventions in persons with autism. Following the PRISMA guidelines, a systematic search of MEDLINE, CINAHL, PsycINFO, The Cochrane Library, Google Scholar, and Opengrey was performed. Nine articles (all case reports or case series) were included. Methodological quality was assessed using the Mayo Evidence-Based Practice Centre tool. The included studies considered 17 subjects (16 males; age range: 4–15 years). All studies reported a reduction of TW frequency, but the follow-up was lacking in seven studies. There is a lack of high-quality studies with a sufficiently large and well-characterized sample to assess the effectiveness of TW interventions in autistic persons. These findings strongly support the need for further research in this area.
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Tosatto D, Bonacina D, Signori A, Pellicciari L, Cecchi F, Cornaggia CM, Piscitelli D. Spin of information and inconsistency between abstract and full text in RCTs investigating upper limb rehabilitation after stroke: An overview study. Restor Neurol Neurosci 2022; 40:195-207. [PMID: 35723125 DOI: 10.3233/rnn-211247] [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] [Indexed: 11/15/2022]
Abstract
BACKGROUND Researchers may be tempted to favorably distort the interpretation of their findings when reporting the abstract (i.e., spin). Spin bias overemphasizes the beneficial effects of the intervention compared with the results shown in the full text. OBJECTIVE To assess the occurrence of spin bias and incompleteness in reporting abstracts in post-stroke upper limb (UL) rehabilitation randomized clinical trials (RCTs). METHODS A sample of 120 post-stroke UL rehabilitation RCTs (indexed in PEDro database), published in English between 2012 and 2020, was included. The completeness of reporting and spin were assessed using the Consolidated Standards of Reporting Trials for Abstracts (CONSORT-A) and the spin checklist. The relationship between CONSORT-A and spin checklist scores with RCT and journal characteristics was assessed. RESULTS CONSORT-A and spin checklist scored 5.3±2.4 (max 15-points, higher scores indicating better reporting) and 5.5±2.0 (max 7-points, higher scores indicating presence of spin), respectively; Significant differences were detected between abstract and full-text scores in the CONSORT-A checklist (p < 0.01) and the spin checklist (p < 0.01). Items of the CONSORT-A checklist in the abstracts and full text showed a fair agreement (k = 0.31), while a moderate agreement (k = 0.59) for the spin checklist was detected. Completeness of abstract was associated (R2 = 0.46) with journal Impact Factor (p < 0.01), CONSORT Guideline endorsement (p = 0.04), and abstract word number (p = 0.02). A lower spin was associated with a higher journal Impact Factor (p = 0.01) and CONSORT Guideline endorsement (p = 0.01). CONCLUSIONS Post-stroke UL rehabilitation RCTs abstracts were largely incomplete showing spin. Authors, reviewers, publishers, and stakeholders should be aware of this phenomenon. Publishers should consider allowing more words in abstracts to improve the completeness of reporting abstracts. Although we have investigated only stroke rehabilitation, our results suggest that health care professionals of all disciplines should avoid clinical decision-making based solely upon abstracts.
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Affiliation(s)
- Diego Tosatto
- Istituti Clinici Zucchi - Gruppo San Donato, Carate Brianza (MB), Italy
| | - Daniele Bonacina
- Istituti Clinici Zucchi - Gruppo San Donato, Carate Brianza (MB), Italy
| | - Alessio Signori
- Department of Health Sciences, University of Genoa, Genoa, Italy
| | | | - Francesca Cecchi
- IRCCS Fondazione Don Carlo Gnocchi, Florence, Italy.,Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | | | - Daniele Piscitelli
- School of Medicine and Surgery, University of Milano Bicocca, Milano, Italy.,School of Physical and Occupational Therapy, McGill University, Montreal, Canada.,Department of Kinesiology, University of Connecticut, Storrs, CT, USA
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Basagni B, Hakiki B, Campagnini S, Salvadori E, Grippo A, Paperini A, Castagnoli C, Hochleitner I, Politi AM, Gemignani P, Mosca IE, Franceschini A, Bonotti EB, Sodero A, Mannini A, Pellicciari L, Poggesi A, Macchi C, Carrozza MC, Cecchi F. Critical issue on the extinction and inattention subtest of NIHSS scale: an analysis on post-acute stroke patients attending inpatient rehabilitation. BMC Neurol 2021; 21:475. [PMID: 34879861 PMCID: PMC8653531 DOI: 10.1186/s12883-021-02499-9] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Accepted: 11/18/2021] [Indexed: 11/17/2022] Open
Abstract
Objectives This study aims to evaluate the diagnostic performance of NIHSS extinction and inattention item, compared to the results of the Oxford Cognitive Screen (OCS) heart subtest. Additionally, the possible role of the NIHSS visual field subtest on the NIHSS extinction and inattention subtest performance is explored and discussed. Methods We analysed scores on NIHSS extinction and inattention subtest, NIHSS visual field subtest, and OCS heart subtest on a sample of 118 post-stroke patients. Results Compared to OCS heart subtest, the results on NIHSS extinction and inattention subtest showed an accuracy of 72.9% and a moderate agreement level (Cohen’s kappa = 0.404). Furthermore, a decrease in NIHSS accuracy detecting neglect (61.1%) was observed in patients with pathological scores in NIHSS visual field item. Conclusions Extreme caution is recommended for the diagnostic performance of extinction and inattention item of NIHSS. Signs of neglect may not be detected by NIHSS, and may be confused with visual field impairment. Trial registration This study refers to an observational study protocol submitted to ClinicalTrials.gov with identifier: NCT03968627. The name of the registry is “Development of a National Protocol for Stroke Rehabilitation in a Multicenter Italian Institution” and the date of the registration is the 30th May 2019.
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Affiliation(s)
- Benedetta Basagni
- IRCCS Fondazione Don Carlo Gnocchi, Via di Scandicci 269 -, 50143, Florence, Italy
| | - Bahia Hakiki
- IRCCS Fondazione Don Carlo Gnocchi, Via di Scandicci 269 -, 50143, Florence, Italy
| | - Silvia Campagnini
- IRCCS Fondazione Don Carlo Gnocchi, Via di Scandicci 269 -, 50143, Florence, Italy. .,The Biorobotics Institute, Scuola Superiore Sant'Anna, Pontedera, Italy.
| | - Emilia Salvadori
- IRCCS Fondazione Don Carlo Gnocchi, Via di Scandicci 269 -, 50143, Florence, Italy.,Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Antonello Grippo
- IRCCS Fondazione Don Carlo Gnocchi, Via di Scandicci 269 -, 50143, Florence, Italy
| | - Anita Paperini
- IRCCS Fondazione Don Carlo Gnocchi, Via di Scandicci 269 -, 50143, Florence, Italy
| | - Chiara Castagnoli
- IRCCS Fondazione Don Carlo Gnocchi, Via di Scandicci 269 -, 50143, Florence, Italy
| | - Ines Hochleitner
- IRCCS Fondazione Don Carlo Gnocchi, Via di Scandicci 269 -, 50143, Florence, Italy
| | - Angela Maria Politi
- IRCCS Fondazione Don Carlo Gnocchi, Via di Scandicci 269 -, 50143, Florence, Italy
| | - Paola Gemignani
- IRCCS Fondazione Don Carlo Gnocchi, Via di Scandicci 269 -, 50143, Florence, Italy
| | - Irene Eleonora Mosca
- IRCCS Fondazione Don Carlo Gnocchi, Via di Scandicci 269 -, 50143, Florence, Italy
| | - Azzurra Franceschini
- IRCCS Fondazione Don Carlo Gnocchi, Via di Scandicci 269 -, 50143, Florence, Italy
| | - Enrico Bacci Bonotti
- IRCCS Fondazione Don Carlo Gnocchi, Via di Scandicci 269 -, 50143, Florence, Italy
| | - Alessandro Sodero
- IRCCS Fondazione Don Carlo Gnocchi, Via di Scandicci 269 -, 50143, Florence, Italy.,Department of Neuroscience, Psychology, Drug Research and Child Health, University of Florence, Florence, Italy
| | - Andrea Mannini
- IRCCS Fondazione Don Carlo Gnocchi, Via di Scandicci 269 -, 50143, Florence, Italy.,The Biorobotics Institute, Scuola Superiore Sant'Anna, Pontedera, Italy
| | - Leonardo Pellicciari
- IRCCS Fondazione Don Carlo Gnocchi, Via di Scandicci 269 -, 50143, Florence, Italy
| | - Anna Poggesi
- IRCCS Fondazione Don Carlo Gnocchi, Via di Scandicci 269 -, 50143, Florence, Italy.,Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Claudio Macchi
- IRCCS Fondazione Don Carlo Gnocchi, Via di Scandicci 269 -, 50143, Florence, Italy.,Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | | | - Francesca Cecchi
- IRCCS Fondazione Don Carlo Gnocchi, Via di Scandicci 269 -, 50143, Florence, Italy.,Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
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Piscitelli D, Ferrarello F, Ugolini A, Verola S, Pellicciari L. Measurement properties of the Gross Motor Function Classification System, Gross Motor Function Classification System-Expanded & Revised, Manual Ability Classification System, and Communication Function Classification System in cerebral palsy: a systematic review with meta-analysis. Dev Med Child Neurol 2021; 63:1251-1261. [PMID: 34028793 DOI: 10.1111/dmcn.14910] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/30/2021] [Indexed: 01/15/2023]
Abstract
AIM To systematically review and meta-analyse the measurement properties of the Gross Motor Function Classification System (GMFCS), Gross Motor Function Classification System-Expanded & Revised (GMFCS-E&R), Manual Ability Classification System (MACS), and Communication Function Classification System (CFCS) in children with cerebral palsy (CP). METHOD Six databases were searched. Articles on the measurement properties of the GMFCS, GMFCS-E&R, MACS, and CFCS administered to children with CP were included. Quality was assessed by means of the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) Risk of Bias checklist. The level and grading of evidence were defined for each measurement property. RESULTS Forty-four articles were included in the systematic review and 37 articles were included in the meta-analysis. The level (grading) of evidence was strong (positive) for reliability and construct validity. Content validity displayed an unknown level of evidence for the GMFCS, limited evidence (positive) for the MACS, and moderate evidence (positive) for the CFCS. There was moderate (positive) evidence for measurement error in the GMFCS and MACS. The level of evidence for responsiveness was unknown. No studies investigated cross-cultural validity. INTERPRETATION These instruments can be used by health care professionals and caregivers to quantify the constructs needed to measure ability in children with CP. Current high-quality evidence supports the use of these tools to classify ability in children with CP. Adopting the COSMIN guidelines, content, and cross-cultural validity should be investigated further. What this paper adds Strong evidence supports the reliability and construct validity of the GMFCS, GMFCS-E&R, MACS, and CFCS as functional classification systems in children with cerebral palsy. The GMFCS, GMFCS-E&R, MACS, and CFCS can be used by both health care professionals and caregivers. The GMFCS, GMFCS-E&R, MACS, and CFCS should not be used to detect change.
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Affiliation(s)
- Daniele Piscitelli
- School of Physical and Occupational Therapy, McGill University, Montreal, Canada.,School of Medicine and Surgery, University of Milano Bicocca, Milan, Italy
| | | | | | - Sofia Verola
- Program in Physical Therapy, University of Florence, Florence, Italy
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Pellicciari L, Chiarotto A, Giusti E, Crins MHP, Roorda LD, Terwee CB. Psychometric properties of the patient-reported outcomes measurement information system scale v1.2: global health (PROMIS-GH) in a Dutch general population. Health Qual Life Outcomes 2021; 19:226. [PMID: 34579721 PMCID: PMC8477486 DOI: 10.1186/s12955-021-01855-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Accepted: 09/03/2021] [Indexed: 12/21/2022] Open
Abstract
Purpose To assess the psychometric properties of the Dutch-Flemish Patient-Reported Outcome Measurement Information System Scale v1.2 – Global Health (PROMIS-GH). Methods The PROMIS-GH (also referred to as PROMIS-10) was administered to 4370 persons from the Dutch general population. Unidimensionality (CFI ≥ 0.95; TLI ≥ 0.95; RMSEA ≤ 0.06; SRMR ≤ 0.08), local independence (residual correlations < 0.20), monotonicity (H > 0.30), model fit with the Graded Response Model (GRM, p < 0.001), internal consistency (alpha > 0.75), precision (total score information across the latent trait), measurement invariance (no Differential Item Functioning [DIF]), and cross-cultural validity (no DIF for language, Dutch vs. United States English) of its subscales, composed of four items each, Global Mental Health (GMH) and Global Physical Health (GPH), were assessed. Results Confirmatory factor analyses, on both subscales, revealed slight departures from unidimensionality for GMH (CFI = 0.98; TLI = 0.95, RMSEA = 0.22; SRMR = 0.04) and GPH (CFI = 0.99; TLI = 0.97; RMSEA = 0.12; SRMR = 0.03). Local independence, monotonicity, GRM model fit, internal consistency, precision and cross-cultural validity were supported. However, Global10 (emotional problems) showed misfit on the GMH subscale, while Global08 (fatigue) presented DIF for age. Conclusion The psychometric properties of the PROMIS-GH in the Dutch population were considered acceptable. Sufficient local independence, monotonicity, GRM fit, internal consistency, measurement invariance and cross-cultural validity were found. If future studies find similar results, structural validity of the GMH could be enhanced by improving or replacing Global10 (emotional problems). Supplementary Information The online version contains supplementary material available at 10.1186/s12955-021-01855-0.
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Affiliation(s)
| | - Alessandro Chiarotto
- Department of Health Sciences, Amsterdam Movement Sciences Research Institute, VU University, Amsterdam, The Netherlands.,Department of General Practice, Erasmus MC, , University Medical Center, Rotterdam, The Netherlands
| | - Emanuele Giusti
- Psychology Research Laboratory, IRCCS Istituto Auxologico Italiano, Milan, Italy.,Department of Psychology, Catholic University of the Sacred Heart, Milan, Italy
| | - Martine H P Crins
- Amsterdam Rehabilitation Research Center
- Reade, Amsterdam, The Netherlands.,Zuyderland MC Department of Quality and Safety, Amsterdam, The Netherlands
| | - Leo D Roorda
- Amsterdam Rehabilitation Research Center
- Reade, Amsterdam, The Netherlands
| | - Caroline B Terwee
- Department of Epidemiology and Data Science, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, de Boelelaan 1089a, 1081 HV, Amsterdam, The Netherlands.
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Mourad F, Lopez G, Cataldi F, Maselli F, Pellicciari L, Salomon M, Kranenburg H, Kerry R, Taylor A, Hutting N. Assessing Cranial Nerves in Physical Therapy Practice: Findings from a Cross-Sectional Survey and Implication for Clinical Practice. Healthcare (Basel) 2021; 9:1262. [PMID: 34682942 PMCID: PMC8535196 DOI: 10.3390/healthcare9101262] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2021] [Revised: 09/14/2021] [Accepted: 09/17/2021] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND AND OBJECTIVE Serious pathologies of the neck can potentially result in cranial nerve palsy. Knowledge about cranial nerve examination (CNE) seems sparse, and its use is still unknown. We aim to investigate the knowledge, skills, and utilization of CNE of Italian physiotherapists. MATERIALS AND METHODS An online cross-sectional survey. RESULTS 396 completed the survey, reaching the required sample size. Although Italian physiotherapists consider CNE relevant (mean ± SD = 7.6/10 ± 2.0), over half of all responders (n = 229 (57.8%)) were not trained in the fundamentals and around a third did not use it in their daily practice (n = 138 (34.8%)). Additionally, participants were unconfident and insecure in conducting (n = 152 (38.4%) and n = 147 (37.1%)), interpreting (n = 140 (35.4%) and n = 164 (41.4%)), and managing the CNE (n = 141 (35.6%) and n = 154 (38.9%)). Possessing a musculoskeletal specialization was associated with an increased value attributed to clinical practice guidelines and reduced the lack of confidence in conducting, interpreting, and managing the CNE (respectively, n = 35 (25.5%), p = 0.0001; n = 32 (23.4%) p = 0.0002; n = 32 (23.4%) p = 0.0002). Working in a direct access setting significantly increased the considered relevance of guidelines and the concerns about arterial (p = 0.004) and other serious pathologies (p = 0.021). Pain and visual disturbances were considered the main indicators to CNE, demonstrating limited knowledge of signs and symptoms' indicating CNE. Participants considered specific training in CNE as relevant (mean ± SD = 7.6/10 = 2.1). CONCLUSIONS a substantial proportion of Italian physiotherapists are not schooled in the fundamentals of cranial nerve examination. Given the number of physiotherapists who work in first contact roles, this is a professional concern.
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Affiliation(s)
- Firas Mourad
- Department of Physiotherapy, LUNEX International University of Health, Exercise and Sports, 4671 Differdange, Luxembourg;
- Luxembourg Health & Sport Sciences Research Institute A.s.b.l., 50, Avenue du Parc des Sports, 4671 Differdange, Luxembourg
- Department of Clinical Science and Translation Medicine, Faculty of Medicine and Surgery, University of Rome Tor Vergata, 00133 Roma, Italy; (G.L.); (F.C.); (M.S.)
| | - Giovanni Lopez
- Department of Clinical Science and Translation Medicine, Faculty of Medicine and Surgery, University of Rome Tor Vergata, 00133 Roma, Italy; (G.L.); (F.C.); (M.S.)
- Department of Physiotherapy, Kinesis, 70126 Bari, Italy
| | - Fabio Cataldi
- Department of Clinical Science and Translation Medicine, Faculty of Medicine and Surgery, University of Rome Tor Vergata, 00133 Roma, Italy; (G.L.); (F.C.); (M.S.)
- Department of Physiotherapy, Manual Therapy Laboratory—MTLab, 70123 Bari, Italy
| | - Filippo Maselli
- Sovrintendenza Sanitaria Regionale Puglia INAIL, 70126 Bari, Italy
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetic and Maternal Infantile Sciences (DINOGMI), Campus of Savona, University of Genova, 16132 Savona, Italy
| | | | - Mattia Salomon
- Department of Clinical Science and Translation Medicine, Faculty of Medicine and Surgery, University of Rome Tor Vergata, 00133 Roma, Italy; (G.L.); (F.C.); (M.S.)
- Department of Physical Therapy, Centro Diagnostico e Polispecialistico CST S.r.l., 38121 Trento, Italy
| | - Hendrikus Kranenburg
- Research Group Healthy Ageing, Allied Health Care and Nursing, Hanze University of Applied Sciences, 9714 CE Groningen, The Netherlands;
| | - Roger Kerry
- Division of Physiotherapy and Sport Rehabilitation, School of Health Sciences, Faculty of Medicine and Health Sciences, Nottingham University, Nottingham NG5 1PB, UK; (R.K.); (A.T.)
| | - Alan Taylor
- Division of Physiotherapy and Sport Rehabilitation, School of Health Sciences, Faculty of Medicine and Health Sciences, Nottingham University, Nottingham NG5 1PB, UK; (R.K.); (A.T.)
| | - Nathan Hutting
- Department of Occupation and Health, School of Organisation and Development, HAN University of Applied Sciences, 6503 GL Nijmegen, The Netherlands;
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Margelli M, Segat A, Raule M, Giacchetti C, Zanoli G, Pellicciari L. A reliability study of a novel visual ischemic palpation scale in an experimental setting. Musculoskelet Sci Pract 2021; 54:102384. [PMID: 33992885 DOI: 10.1016/j.msksp.2021.102384] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Revised: 04/20/2021] [Accepted: 04/25/2021] [Indexed: 11/18/2022]
Abstract
BACKGROUND Manual palpation is an important part of the clinical examination and generally it has low reliability. The aim of this study was to assess the reliability of a novel method for discriminating 3 different levels of palpation force. METHODS This reliability study included 96 healthy physiotherapists and physiotherapy students, who have been taught a new palpation graduated procedure called Visual Ischemic Palpatory Scale (VIPS), aimed to classify the applied pressure based on the finger's ischemia. Force was recorded by a force measurement system putting sensor over a rigid surface. To study the characteristic of VIPS the analysis of variance (ANOVA), Spearman rank correlation coefficient, Intraclass Correlation Coefficient (ICC), Standard Error of Measurements (SEM), and Minimal Detectable Change (MDC) were calculated. RESULTS Three distinct degrees were found with distinct forces expression: 1st degree 76.04 g (95% CI 65.86-86.22), 2nd degree 307.87 g (95% CI 263.29-352.44) and 3rd degree 1319.48 g (CI 1204.73-1434.23). Male participants significantly recorded a greater force than females. Good to excellent reliability across degrees were found (0.89 [95% CI: 0.82-0.97]), and final agreement found that more than 65.6% of sample recorded a force in the cut-offs identified. SEM values became bigger as the recorded force increased and MDC were equal to 48.94 g, 188.73 g, and 379.24 g for 1st, 2nd, and 3rd degree, respectively. CONCLUSIONS VIPS would appear to have three distinct degrees, sex dependent, with specific force expression for each degree and a good to excellent intra-rater reliability, but a poor agreement between raters.
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Affiliation(s)
- Michele Margelli
- Faculty of Medicine and Surgery, Department of Clinical Ccience and Translation Medicine, University of Rome Tor Vergata, Roma, Italy; Faculty of Medicine and Surgery, Department of Morphology Surgery and Experimental Medicine, University of Ferrara, Ferrara, Italy; Studio Andreotti-Margelli Terapika, Ferrara, Italy.
| | | | - Maddalena Raule
- Faculty of Medicine and Surgery, Department of Morphology Surgery and Experimental Medicine, University of Ferrara, Ferrara, Italy.
| | - Caterina Giacchetti
- Faculty of Medicine and Surgery, Department of Morphology Surgery and Experimental Medicine, University of Ferrara, Ferrara, Italy.
| | - Gustavo Zanoli
- Faculty of Medicine and Surgery, Department of Morphology Surgery and Experimental Medicine, University of Ferrara, Ferrara, Italy; Casa di Cura SM Maddalena, Occhiobello, Italy.
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Paci M, Faedda G, Ugolini A, Pellicciari L. Barriers to evidence-based practice implementation in physiotherapy: a systematic review and meta-analysis. Int J Qual Health Care 2021; 33:6295946. [PMID: 34110410 DOI: 10.1093/intqhc/mzab093] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [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: 10/25/2020] [Revised: 04/09/2021] [Accepted: 06/10/2021] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND To review and meta-analyse the evidence about the prevalence of barriers to evidence-based practice (EBP) reported in physiotherapy. METHODS Two independent investigators conducted an extensive electronic search in EMBASE, PubMed, Scopus, Web of Science and CINAHL databases from their inception to July 2020 and included the retrieved articles if they investigated barriers to EBP among physiotherapy professionals. Subsequently, they extracted data and assessed the methodological quality using a scale described in a similar previous study. The outcome for meta-analysis was frequency of each reported barrier. Sub-analyses were performed grouping studies based on countries where surveys were performed, classified as either developed or developing countries. RESULTS Twenty-nine articles were included in the systematic reviews and meta-analysis. Risk of bias assessment of included studies showed a median score: 4 points (interquartile range: 3-4). The findings of meta-analysis revealed that lack of time was the most frequently reported barrier (53.0% [95% confidence interval, 95%CI, 44.0-62.0]), followed by language (36.0% [95%CI 16.0-62.0]), lack of access (34.0% [95%CI 23.0.27]) and lack of statistical skills (31.0% [95%CI 20.0-44.0]). Lack of skills and lack of generalizability were declared as barriers by 27.0% [95%CI 18.0-38.0] and 23.0% [95%CI 15.0-33.0] of responders, respectively. Lack of support and lack of interest are less frequent, with 16.0% [95%CI 11.0-24.0] and 9.0% [95%CI 6.0-15.0] of responses, respectively. Barriers reported in investigations performed in developed countries were less frequent when compared to those performed in developing countries. CONCLUSION Organizational issues and methodological skills seem key issues to allow the implementation of EBP, suggesting the need to adopt or enhance organizational and training strategies to facilitate the implementation of the EBP. Quantitative synthesis showed high heterogeneity for all analyses, and therefore, pooled data should be interpreted with caution.
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Affiliation(s)
- Matteo Paci
- Unit of Functional Rehabilitation, Azienda USL Toscana Centro, Viale Michelangiolo, 41, Florence 50125, Italy
| | - Gianni Faedda
- Graduate Course in Rehabilitation Sciences, University of Florence, Largo Brambilla, 3, Florence 50134, Italy
| | - Alessandro Ugolini
- Program in Physical Therapy, University of Florence, Largo Brambilla, 3, Florence 50134, Italy
| | - Leonardo Pellicciari
- IRCCS Fondazione Don Carlo Gnocchi, Via di Scandicci, 269 I, Florence 50143, Italy
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44
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Brindisino F, De Santis A, Rossettini G, Pellicciari L, Filipponi M, Rollo G, Gibson J. Post-surgery rehabilitation following rotator cuff repair. A survey of current (2020) Italian clinical practice. Disabil Rehabil 2021; 44:4689-4699. [PMID: 33945358 DOI: 10.1080/09638288.2021.1916628] [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] [Indexed: 10/21/2022]
Abstract
AIMS To analyse the clinical practice of Italian physiotherapists within the framework of postoperative rehabilitation of rotator cuff (RC) surgery patients, and to compare it with similar studies carried out in other countries. METHODS A web-based, voluntary, cross-sectional survey with 27 closed multiple-choice questions was developed and submitted to Italian-based physiotherapists in order to assess their clinical practice. RESULTS Data from 1160 questionnaires were then analysed. Thirty-five percent of respondents (n = 413/1160) reported that they commence passive range of motion from the first postoperative week, while 49.2% (n = 571/1160) start during the second or third week. The majority of respondents (n = 603/1160, 52.0%) introduce active mobilisation between the fourth and the sixth week after surgery and 41.1% (n = 477/1160) introduce overhead movements between the fourth and the sixth week after surgery. DISCUSSION AND CONCLUSIONS When managing the postoperative rehabilitation of RC surgery patients, Italian physiotherapists' practice is congruent with the guidelines published by American Society of Shoulder and Elbow Therapists (ASSET) and also with other UK surveys. However, while Italian physiotherapists manage immobilisation periods, active and passive mobilisation and the return to sport activities, according to evidence-based best practice guidelines, there is less consistency with respect to physical exercise, patient follow-up and referral.IMPLICATIONS FOR REHABILITATIONItalian physiotherapists' practice with patients following rotator cuff (RC) repair complies with evidence-based practice guidelines regarding immobilisation periods, passive and active mobilisation, and return to sport activities.There is less consistency between reported/declared practice and available evidence concerning physical exercise, patient follow-up, and referral.Physiotherapist with Orthopaedic Manipulative Physical Therapy (OMPT) training is more aligned with the current literature compared to physiotherapists without specific training, in terms of managing rehabilitation programmes, period of immobilisation and therapeutic exercise.More careful adherence to the international guidelines is recommended, in order to manage patients following RC repair in accordance with the evidence and to achieve the best possible outcomes.
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Affiliation(s)
- Fabrizio Brindisino
- Department of Medicine and Health Science "Vincenzo Tiberio", University of Molise, Campobasso, Italy.,Department of Clinical Sciences and Translational Medicine, Tor Vergata University of Rome, Rome, Italy
| | - Andrea De Santis
- Department of Medicine and Health Science "Vincenzo Tiberio", University of Molise, Campobasso, Italy.,Poliambulatorio Physiofit, Borgo Podgora, Italy
| | - Giacomo Rossettini
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genova, Genova, Italy.,School of Physiotherapy, University of Verona, Verona, Italy
| | | | - Marco Filipponi
- Department of Orthopedics and Traumatology, Vito Fazzi Hospital, Lecce, Italy
| | - Giuseppe Rollo
- Department of Orthopedics and Traumatology, Vito Fazzi Hospital, Lecce, Italy
| | - Jo Gibson
- Department of Physiotherapy, Royal Liverpool and Broadgreen Hospitals NHS Trust, Liverpool, UK.,The School of Health Sciences, University of Liverpool, Liverpool, UK
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Pellicciari L, Agosti M, Goffredo M, Pournajaf S, Le Pera D, De Pisi F, Franceschini M, Damiani C. Factors Influencing Functional Outcome at Discharge: A Retrospective Study on a Large Sample of Patients Admitted to an Intensive Rehabilitation Unit. Am J Phys Med Rehabil 2021; 100:483-491. [PMID: 32889862 DOI: 10.1097/phm.0000000000001582] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE Functional outcome represents the most central objective of rehabilitation programs. Understanding which factors could affect functional status at discharge is crucial for the planning of appropriate treatments in both neurologic and orthopedic patients. The aim of this study was to investigate which clinical and demographic variables, collected at the patient's admission, could influence the functional outcome, assessed by the modified Barthel Index (mBI), at discharge. DESIGN A retrospective study was conducted on a large cohort (n = 3548) of orthopedic and neurologic patients. Functional, demographic, and clinical records at patient admission and mBI score at discharge were collected. General linear model analysis was performed to assess the influence of these variables on functional outcome at discharge. RESULTS The results reported a significant effect of mBI score at admission (P < 0.0001), age (P < 0.0001), and time from the acute event (P < 0.0001) on mBI score at discharge. Moreover, the disease type (neurologic or orthopedic) adjusted by sex (male or female) and presence of different impairments (cognitive and behavioral impairments) and complications (hypertension and cardiovascular diseases) significantly influenced mBI score at discharge (P < 0.05) (R2 = 0.497). No significant interactions between other factors were found (P > 0.05). CONCLUSION Several prognostic factors should be considered when planning an appropriate tailored rehabilitation program.
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Affiliation(s)
- Leonardo Pellicciari
- From the Neurorehabilitation Research Laboratory, IRCCS San Raffaele Pisana, Rome, Italy (LP, MG, SP, DLP, FDP, MF, CD); Rehabilitation Medicine Service, Rehabilitation Geriatrics Department of the NHS-University Hospital of Parma, Parma, Italy (MA); and San Raffaele University, Rome, Italy (MF)
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Scalise V, Brindisino F, Pellicciari L, Minnucci S, Bonetti F. Carpal Tunnel Syndrome: A National Survey to Monitor Knowledge and Operating Methods. Int J Environ Res Public Health 2021; 18:ijerph18041995. [PMID: 33670831 PMCID: PMC7922196 DOI: 10.3390/ijerph18041995] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Revised: 02/09/2021] [Accepted: 02/12/2021] [Indexed: 11/21/2022]
Abstract
The aim of this article was to investigate the knowledge, management, and clinical practice of Italian physiotherapists concerning patients with carpal tunnel syndrome (CTS). A national cross-sectional survey consisted of 24 questions was administered from December 2019 until February 2020. A Chi-squared independence test was run to study any difference between subgroups of the sample and responses to the questionnaire. Five hundred and eight respondents completed the survey. Most respondents (n = 225/508; 44.3%) are under 29 years old, female (n = 256/508; 50.4%) and have been working as physiotherapists for less than 5 years (n = 213/508; 41.9%). Most of respondents correctly knows about the cause (n = 455/508, 89.6%), main signs and symptoms of CTS (n = 415/508, 81.70%) and administer education, manual therapy, myofascial techniques and therapeutic exercises (n = 457/508, 89.88%). Three hundred and sixty-four (71.68%) respondents were aware of the influence of psychosocial factors on the patient’s outcomes. The survey showed greater adherence to evidences by physiotherapists holding a master’s degree. The results are mostly comparable with other surveys structured all over the world on the same topic. Italian physiotherapists management of the CTS was not always in line with current evidence. Interventions such as education, manual therapy, therapeutic exercise, nerve and tendon glide techniques are widely used, while the orthotic is only offered by half of the sample.
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Affiliation(s)
- Valentina Scalise
- Department of Clinical Sciences and Translational Medicine, University of Rome Tor Vergata, I-00133 Rome, Italy; (V.S.); (F.B.); (S.M.); (F.B.)
| | - Fabrizio Brindisino
- Department of Clinical Sciences and Translational Medicine, University of Rome Tor Vergata, I-00133 Rome, Italy; (V.S.); (F.B.); (S.M.); (F.B.)
- Department of Medicine and Health Science “Vincenzo Tiberio”, University of Molise, I-86100 Campobasso, Italy
| | - Leonardo Pellicciari
- Neurorehabilitation Research Laboratory, IRCCS San Raffaele Pisana, I-00166 Rome, Italy
- Correspondence: or ; Tel.: +39-32-8568-2656
| | - Silvia Minnucci
- Department of Clinical Sciences and Translational Medicine, University of Rome Tor Vergata, I-00133 Rome, Italy; (V.S.); (F.B.); (S.M.); (F.B.)
| | - Francesca Bonetti
- Department of Clinical Sciences and Translational Medicine, University of Rome Tor Vergata, I-00133 Rome, Italy; (V.S.); (F.B.); (S.M.); (F.B.)
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Ravizzotti E, Vercelli S, Pellicciari L, Furmanek MP, Zagnoni G, Piscitelli D. Reliability and Validity of the Trunk Control Measurement Scale Among Children and Adolescents With Cerebral Palsy in Tanzania. Percept Mot Skills 2020; 128:731-745. [PMID: 33357090 DOI: 10.1177/0031512520983701] [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] [Indexed: 11/16/2022]
Abstract
The aim of this study was to investigate the reliability and validity of the Trunk Control Measurement Scale (TCMS) among children with cerebral palsy (CP) who were living in Tanzania. Two physiotherapy trainees, each blinded to the other's test findings, independently administered the TCMS to 38 children with CP (16 female; M age = 7.2, SD = 4.8 years) twice over sessions separated by a 30-day interval. We assessed internal consistency and intra/inter-rater reliability using Cronbach's alpha and the Intraclass Correlation Coefficient (ICC), respectively. We examined measurement error through Standard Error of Measurement (SEM) and Minimal Detectable Change (MDC). We assessed construct validity with Spearman's correlation coefficient between the TCMS and both the Gross Motor Function Classification System (GMFCS) and the Manual Ability Classification System (MACS). We found a frank floor effect. Internal consistency (α = 0.945) and reliability indices were excellent for the total scale (ICC for intra-rater reliability = 0.985, inter- reliability = 0.997) and for each sub-scale score. We found low values of SEM (1.7 points) and MDC (4.8 points). Construct validity was supported by moderate and strong correlations between the TCMS and the GMFCS and MACS in this sample. We conclude that the psychometric properties of the TMCS support its clinical and research use for youth with CP in low-income settings.
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Affiliation(s)
| | - Stefano Vercelli
- Laboratory of Ergonomics and Musculoskeletal Disorders Assessment, Division of Physical Medicine and Rehabilitation, Istituti Clinici Scientifici Maugeri, IRCCS, Pavia, Italy
| | | | - Mariusz P Furmanek
- Institute of Sport Sciences, The Jerzy Kukuczka Academy of Physical Education in Katowice, Katowice, Poland.,Department of Physical Therapy, Movement, and Rehabilitation Science, Bouvé College of Health Science, Northeastern University, Boston, Massachusetts. United States
| | - Giulia Zagnoni
- Nyumba Ali Organization, Bologna, Italy.,School of Medicine, Program in Physical Therapy, University of Bologna, Bologna, Italy
| | - Daniele Piscitelli
- Nyumba Ali Organization, Bologna, Italy.,School of Medicine and Surgery, University of Milano Bicocca, Milano, Italy
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Pellicciari L, Piscitelli D, Basagni B, De Tanti A, Algeri L, Caselli S, Ciurli MP, Conforti J, Estraneo A, Moretta P, Gambini MG, Inzaghi MG, Lamberti G, Mancuso M, Rinaldesi ML, Sozzi M, Abbruzzese L, Zettin M, La Porta F. 'Less is more': validation with Rasch analysis of five short-forms for the Brain Injury Rehabilitation Trust Personality Questionnaires (BIRT-PQs). Brain Inj 2020; 34:1741-1755. [PMID: 33180650 DOI: 10.1080/02699052.2020.1836402] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
BACKGROUND Previous analyses demonstrated a lack of unidimensionality, item redundancy, and substantial administrative burden for the Brain Injury Rehabilitation Trust Personality Questionnaires (BIRT-PQs). OBJECTIVE To use Rasch Analysis to calibrate five short-forms of the BIRT-PQs, satisfying the Rasch model requirements. METHODS BIRT-PQs data from 154 patients with severe Acquired Brain Injury (s-ABI) and their caregivers (total sample = 308) underwent Rasch analysis to examine their internal construct validity and reliability according to the Rasch model. RESULTS The base Rasch analyses did not show sufficient internal construct validity according to the Rasch model for all five BIRT-PQs. After rescoring 18 items, and deleting 75 of 150 items, adequate internal construct validity was achieved for all five BIRT-PQs short forms (model chi-square p-values ranging from 0.0053 to 0.6675), with reliability values compatible with individual measurements. CONCLUSIONS After extensive modifications, including a 48% reduction of the item load, we obtained five short forms of the BIRT-PQs satisfying the strict measurement requirements of the Rasch model. The ordinal-to-interval measurement conversion tables allow measuring on the same metric the perception of the neurobehavioral disability for both patients with s-ABI and their caregivers.
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Affiliation(s)
- Leonardo Pellicciari
- Neurorehabilitation Research Laboratory, IRCCS San Raffaele Pisana , Rome, Italy
| | - Daniele Piscitelli
- School of Physical and Occupational Therapy, McGill University , Montreal, Canada.,School of Medicine and Surgery, University of Milano Bicocca , Milan, Italy.,School of Physical Therapy and Athletic Training, Pacific University , Hillsboro, OR, USA
| | - Benedetta Basagni
- Cardinal Ferrari Centre, S. Stefano Rehabilitation , Fontanellato (PR), Italy
| | - Antonio De Tanti
- Cardinal Ferrari Centre, S. Stefano Rehabilitation , Fontanellato (PR), Italy
| | - Lorella Algeri
- UOC Psicologia, ASST Papa Giovanni XXIII , Bergamo, Italy
| | - Serena Caselli
- Unità Operativa di Medicina Riabilitativa, Dipartimento di Neuroscienze, Azienda Ospedaliero-Universitaria di Modena , Modena, Italy.,Scuola di Dottorato in Sanità Pubblica, Università degli Studi di Milano-Bicocca , Milano, Italy
| | | | - Jessica Conforti
- Cardinal Ferrari Centre, S. Stefano Rehabilitation , Fontanellato (PR), Italy
| | - Anna Estraneo
- Severe Brain Injury Department, IRCCS Don Gnocchi Institute , Florence, Italy.,Neurology Unit, Santa Maria della Pietà General Hospital , Nola, Italy
| | - Pasquale Moretta
- Maugeri Scientific and Clinical Institutes, IRCCS, Department of Neurorehabilitation, Institute of Telese Terme , Telese Terme, Italy
| | - Maria Grazia Gambini
- Dipartimento di Riabilitazione, Ospedale Sacro Cuore- Don Calabria , Verona, Italy
| | | | | | - Mauro Mancuso
- Department of Rehabilitation, National Health Service South-Est Tuscany , Grosseto, Italy.,Research Centre, Tuscany Rehabilitation Clinic , Montevarchi, Italy
| | - Maria Luisa Rinaldesi
- Santo Stefano Riabilitazione, Istituto di Riabilitazione Santo Stefano , Porto Potenza Picena, Italy
| | - Matteo Sozzi
- Neurology Unit, "A. Manzoni" Hospital , Lecco, Italy
| | - Laura Abbruzzese
- Research Centre, Tuscany Rehabilitation Clinic , Montevarchi, Italy
| | - Marina Zettin
- Centro Puzzle , Turin, Italy.,Dipartimento di Psicologia, Università di Torino , Turin, Italy
| | - Fabio La Porta
- IRCCS Istituto delle Scienze Neurologiche di Bologna, Neurorehabilitation Unit , Bologna, Italy
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Goffredo M, Infarinato F, Pournajaf S, Romano P, Ottaviani M, Pellicciari L, Galafate D, Gabbani D, Gison A, Franceschini M. Barriers to sEMG Assessment During Overground Robot-Assisted Gait Training in Subacute Stroke Patients. Front Neurol 2020; 11:564067. [PMID: 33193001 PMCID: PMC7604287 DOI: 10.3389/fneur.2020.564067] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Accepted: 09/15/2020] [Indexed: 12/20/2022] Open
Abstract
Background: The limitation to the use of ElectroMyoGraphy (sEMG) in rehabilitation services is in contrast with its potential diagnostic capacity for rational planning and monitoring of the rehabilitation treatments, especially the overground Robot-Assisted Gait Training (o-RAGT). Objective: To assess the barriers to the implementation of a sEMG-based assessment protocol in a clinical context for evaluating the effects of o-RAGT in subacute stroke patients. Methods: An observational study was conducted in a rehabilitation hospital. The primary outcome was the success rate of the implementation of the sEMG-based assessment. The number of dropouts and the motivations have been registered. A detailed report on difficulties in implementing the sEMG protocol has been edited for each patient. The educational level and the working status of the staff have been registered. Each member of staff completed a brief survey indicating their level of knowledge of sEMG, using a five-point Likert scale. Results: The sEMG protocol was carried out by a multidisciplinary team composed of Physical Therapists (PTs) and Biomedical Engineers (BEs). Indeed, the educational level and the expertise of the members of staff influenced the fulfillment of the implementation of the study. The PTs involved in the study did not receive any formal education on sEMG during their course of study. The low success rate (22.7%) of the protocol was caused by several factors which could be grouped in: patient-related barriers; cultural barriers; technical barriers; and administrative barriers. Conclusions: Since a series of barriers limited the use of sEMG in the clinical rehabilitative environment, concrete actions are needed for disseminating sEMG in rehabilitation services. The sEMG assessment should be included in health systems regulations and specific education should be part of the rehabilitation professionals' curriculum. Clinical Trial Registration: www.ClinicalTrials.gov, identifier: NCT03395717.
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Affiliation(s)
- Michela Goffredo
- Department of Neurological and Rehabilitation Sciences, IRCCS San Raffaele Pisana, Rome, Italy
| | - Francesco Infarinato
- Department of Neurological and Rehabilitation Sciences, IRCCS San Raffaele Pisana, Rome, Italy
| | - Sanaz Pournajaf
- Department of Neurological and Rehabilitation Sciences, IRCCS San Raffaele Pisana, Rome, Italy
| | - Paola Romano
- Department of Neurological and Rehabilitation Sciences, IRCCS San Raffaele Pisana, Rome, Italy
| | - Marco Ottaviani
- Department of Neurological and Rehabilitation Sciences, IRCCS San Raffaele Pisana, Rome, Italy
| | - Leonardo Pellicciari
- Department of Neurological and Rehabilitation Sciences, IRCCS San Raffaele Pisana, Rome, Italy
| | - Daniele Galafate
- Department of Neurological and Rehabilitation Sciences, IRCCS San Raffaele Pisana, Rome, Italy
| | - Debora Gabbani
- Department of Neurological and Rehabilitation Sciences, IRCCS San Raffaele Pisana, Rome, Italy
| | - Annalisa Gison
- Department of Neurological and Rehabilitation Sciences, IRCCS San Raffaele Pisana, Rome, Italy
| | - Marco Franceschini
- Department of Neurological and Rehabilitation Sciences, IRCCS San Raffaele Pisana, Rome, Italy.,Department of Human Sciences and Promotion of the Quality of Life, San Raffaele University, Rome, Italy
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Brindisino F, Ristori D, Lorusso M, Miele S, Pellicciari L, Rossettini G, Bonetti F, Heick JD, Testa M. Subacromial impingement syndrome: a survey of Italian physiotherapists and orthopaedics on diagnostic strategies and management modalities. Arch Physiother 2020; 10:16. [PMID: 32905154 PMCID: PMC7465722 DOI: 10.1186/s40945-020-00087-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Accepted: 07/29/2020] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND AND AIM The subacromial impingement syndrome (SIS) represents a common cause of disability in approximately 74% of patients with Shoulder Pain (SP). Even if contemporary research suggests that this mechanism is not (always) the dominant driver in SP, SIS is still a source of debate among scholars and clinicians. From a clinical point of view, evidence has suggested that clinicians can use both medical and physiotherapy approaches as effective methods to treat SIS.This survey aims to investigate models of management of patients with SIS in a sample of Italian physiotherapist specialists (Orthopaedic Manipulative Physical Therapists, -OMPTs-) and orthopaedic surgeons. MATERIALS AND METHODS An online survey with 29-item questionnaire was administered to assess the knowledge of OMPTs and orthopaedic surgeons about: a) strategies of clinical examination; b) the role of imaging in the diagnostic process; c) the physiotherapy management; and d) the pharmacological and surgical management in patients with SIS. RESULTS Six-hundred and twenty-nine respondents completed the survey (511 OMPTs (79.97%) and 128 orthopaedic surgeons (20.03%)). Ninety-two percent (n = 470) of the OMPTs and 80.5% (n = 103) of orthopaedic surgeons stated that in patients with SIS, a combination of diagnostic tests produced better accuracy (p = < 0.001). Twenty point seven % of OMPTs (n = 106) and 4.7% of orthopaedic surgeon (n = 6) stated that the Lift off was the most specific test (p = < 0.001). Four-hundred-and-twenty-four OMPTs (83%) and 40 orthopaedic surgeons (31.3%) answered that the gold standard for diagnosis of a patient with SIS are history and clinical examination (p < 0.001). CONCLUSION OMPTs and orthopaedic surgeons approach patients with SIS differently during both the assessment and the treatment. OMPTs appear to be appropriate in planning and managing clinical examination and therapeutic strategies to use with patients with SIS.
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Affiliation(s)
- Fabrizio Brindisino
- Department of Medicine and Health Science “Vincenzo Tiberio”, University of Molise C/da Tappino c/o Cardarelli Hospital, 86100 Campobasso, Italy
- Department of Clinical Sciences and Translational Medicine, Tor Vergata University of Rome, Rome, Italy
| | - Diego Ristori
- Department of Neuroscience, Rehabilitation, Ophtalmology, Genetics, Maternal and Child Health – University of Genova – Campus of Savona, Savona, Italy
| | - Mariangela Lorusso
- Department of Clinical Sciences and Translational Medicine, Tor Vergata University of Rome, Rome, Italy
| | - Simone Miele
- Department of Neuroscience, Rehabilitation, Ophtalmology, Genetics, Maternal and Child Health – University of Genova – Campus of Savona, Savona, Italy
| | | | - Giacomo Rossettini
- Department of Neuroscience, Rehabilitation, Ophtalmology, Genetics, Maternal and Child Health – University of Genova – Campus of Savona, Savona, Italy
| | - Francesca Bonetti
- Department of Clinical Sciences and Translational Medicine, Tor Vergata University of Rome, Rome, Italy
| | - John Duane Heick
- Department of Physical Therapy and Athletic Training, Northern Arizona University Flagstaff, Flagstaff, AZ USA
| | - Marco Testa
- Department of Neuroscience, Rehabilitation, Ophtalmology, Genetics, Maternal and Child Health – University of Genova – Campus of Savona, Savona, Italy
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